Crisis in psychiatry and religion

p AN IIMSIGHT BOOK BY VAIM IMOSTRaM

the CRISIS in PSYCHIATRY
fq%l\ and RELIGION

by OJHOBART MOWRER

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OF FLORIDA
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THE CRISIS IN
PSYCHIATRY AND RELIGION

by

O. HOBART MOWRER

University of Illinois

m INSIGHT BOOK

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P'reface

One day, while this book was still in preparation, I
was chatting with a student who, amiably but not very
discerningly, asked if it would be the first to appear
in the psychiatry-religion area. In reply I pointed to
two piles of books, each nearly two feet high, on a
nearby table and suggested that he run his eye down over
the titles. Here, I told him, was only a part of my per-
sonal collection of such books and added that there are
many more which I do not possess.

The more pertinent question, therefore, is why should
I, why should anyone, write yet another book in tLw
area? The answer, to which the prosp?^' reader is
immediately entitled, is that tl^'3 book '- duferent — in a
way which, at least crudely, can be quickly stated. The
typical psychiatry-religion book, subtly or boldly, promises
"peace of mind" to the reader on the premise that psy-
chiatry is wonderful, religion is wonderful, put them
together and you get something better still! More accu-
rately, the situation might be likened to that of two
aging lovers who have married, each with the illusion
taat the other has "lesources" which have been implied
but, thus far, not concretely exhibited. The thesis of
this collection of articles and lectures is that the honey-
moon '3 now coming to an end and that crisis, not
connubial bliss, is the term we need to describe the
resulting situation.

This book contains, therefore, no "prescription for
anxiety," according to the familiar formula. Here we
shall proceed on the assumption that our problems in
this area are not purely ''personal" but have instead
broadly social, historical, scientific, and professional di-
mensions. And the invitation to the reader is thus to
join in a quest and a commitment which, while not
immediately "anxiety reducing," may, in the long run,
be more so than the soothing, personalized approaches

iii

IV

Prefaci

which are today being offered in such profusion. In othei"
words, to borrow a useful distinction from the sociologisl^
C. Wright Mills, it seems that instead of merely having
troubles — of a highly particularized sort, to which there ^
are known, readily available, standard solutions — we here^
face broad and complex issues, which must be recognized^
openly and honestly, and dealt with accordingly. '

Until roughly a century ago, psychology, philosophy^
and religion, in both the popular and academic mind.'
were essentially one discipline. But then, in an attempl'
to separate the empirical from the speculative, the scien-^
tific from the metaphysical, psychology and its medical
counterpart, psychiatry, made a determined effort tc
establish themselves as independent enterprises. In certain
limited respects, this separation or fissioning has been'
successful; but in other, perhaps more important ways,
it has brought serious difficulties in its wake. Human
beings, whether in sickness or in health, are manifestly
not divided into clear-cut psychological, philosophical,
and religious entities. And our efforts, in the separate'
professions, to understand and minister to human need
have been far less effective than we would like. In light
of this situation, it is understandable that, for some years
now, there has been a tendency, particularly on the part
of psychiatry and religion, to "get together" again.
Certainly there is much to commend and support such
a movement; but there are also some major complications
— which constitute the crisis with which this book is
centrally concerned.

Traditionally, it has been recognized that man is pre-
eminently a social being — or, in theological phrase, a
"child of God." However, clinical psychology and psy-
chiatry, in an effort to consolidate their separation from
religion, have been powerfully attracted by the alterna-
tive emphasis of Freudian psychoanalysis upon the bio-
logical, rather than social and moral, nature of man's
deepest aspirations. Currently, in this area, we are hear-
ing a good deal about a new interest in values. More
precisely, we should refer to this as merely a change in
our conception of the good, the valuable. Psychoanalysis
has always had (at least tacitly) a "value system," one
in which "adult genital sexuality" (capacity for lusty
heterosexual orgasm) and unencumbered "assertiveness"

ElEFACE V

vhich often eventuates as frank hostility and aggressive-
^ss) occupy positions of supreme importance.
In psychiatry and cHnical psychology there is now,
elatedly, a growing realization that such a disingenuous
Qorality is more likely to cause than cure personality
Jviation and disorder. But, paradoxically, this re-awaken-
g on the part of the secular professions concerned with
waling is currently a barrier, rather than an asset, in
eir efforts to interact with religion; for the latter has
so been deeply saturated with this same disingenuous
)Ctrine and is having a hard time shaking free of it.
major objective of the present collection of recently
iblished papers and lectures is to facilitate the process
disenchantment and thus help liberate religion for
e more substantial accomplishments, both in conjunc-
)n with psychology and psychiatry and in its own right,
lich seem to be clearly within its reach — and also,
)pefully, to help psychology and psychiatry, in what-
er collaboration with religion may be logically indi-
ted, to develop in more promising and effective di-
ctions.

This book is therefore addressed primarily to psycholo-
its and psychiatrists, on the one hand, and to semi-
jrians and clergymen, on the other, but also to the
mbers of such ''intermediate" professions as educa-
»n, social work, and law. Manifestly it is not a text-
ok, in the conventional sense of the term; yet, on two
Jerent occasions, a mimeographed version thereof has
Ted very satisfactorily in this role. During the Spring
nester of this year, Dr. Perry London and I gave an ad-
nced graduate seminar on "The Nature and Manage-
nt of Guilt," with these materials as the focus of our
ention; and during the summer I also used these ma-
ials as a "text" in a course on "Mental Hygiene for
;achers." But this book will very likely find its greatest
idemic usefulness as supplementary reading and as the
sis for special discussions in a variety of subject-matter
;as.

This is not to say, of course, that more systematic and
borate treatises will not ultimately be written from
I standpoint of the general position which is here
ighly delineated. We are, I believe, definitely in proc-
j of abandoning psychoanalysis, both as personality

VI

PrefacI

theory and as would-be therapy — and also, very possiblj
those forms of theology which have allowed themselvej
to become most seriously adulterated by it. To the d
tent, then, that this book expedites such development'
it is admittedly "negative," ''destructive." But it alsj
points, hopefully and unequivocally, to the social bas'
of both the genesis and correction of psychopatholog*
and thus provides the basis for a broad and potential]
very powerful and constructive attack upon our problen
in this area.

Some readers will, I imagine, sense a similarity h
tween this approach and that somewhat amorphous bi
presently vigorous movement known as Existentialisn
To the extent that the latter is in revolt agairisMth
denial and debasement of human responsibility whic
have been foisted upon us alike by Calvinist theology
Freudian psychoanalysis, and academic Behaviorism, th
present approach is indeed similar. But here the readd
will, I trust, find none of the cultishness and mysticisij
which so often characterize Existentialism, in its varioii
forms. Here the aim is to keep well within the bound
of common sense and scientific thought, but at the sarn
time to take a sufficiently broad view of the human entd
prise to include also a considerable segment of what '
ordinarily termed "morality" and "religion." '

Much of the incentive for bringing this collectio
of documents together in book form comes from tli
friendly, yet thoughtful and concerned way in whic
they have been received, as articles and lectures, by th
various professional and lay groups to which they ha\
been addressed. These reactions have been both a
encouragement and a challenge, for which I am extreme]
grateful. The title of each chapter is followed by
footnote which indicates the chapter's origin: if a
article, the place of prior publication; if a lecture, tli
circumstances of its delivery. And at the outset of eac
chapter there is also a brief introductory statemen
designed to highlight the argument of the book as
whole and to link successive chapters together. Howeve
it is here that I wish to express my very warm appreci.
tion to the Pacific School of Religion for the invitatio
to deliver the E. T. Earl Lectures for 1960 and to Nort
Park College and Seminary for a similar opportunity 1

I^^REFACE Vii

jive the David Nyvall Lectures for 1960. These lectures
ire reproduced in full, as Chapters 8, 9, and 10, and
[l and 12, respectively. And in September, the latter
jvere presented, as the first of the Geehns Lectures for
ihis academic year, at the Southern Baptist Theological
Seminary, in Louisville, Kentucky. I shall long remember,
^^ith much pleasure, the many personal courtesies ex-
fended to me on these occasions and the helpfulness of
he comments and criticisms which I thus received.
! Also, I take pleasure in acknowledging the gener-
osity of those authors and publishers who have granted
permission to quote from other works, and in expressing
py gratitude to Miss Leona D. Pedigo and Mrs. Donald
fV. Keefer for highly competent secretarial assistance in
^e preparation, proofing, and indexing of this book.
I Although the materials here assembled were originally
lirected, in most instances, to professional audiences —
)sychiatrists, psychologists, educators, and theologians,
he language is essentially nontechnical and can be un-
lerstood by any interested layman. And because the issues
mder discussion are so vital to our very existence, both
s individuals and as a people, I believe that many lay-
nen, as well as specialists, will be interested. To this
nd, the book has been deliberately kept small and the
ormat inexpensive.

O. H. M.

Urhana, Illinois

December y I960

Contents

1. Some Philosophical Problems in Psycho-

logical Counseling

2. Changing Conceptions of the Uncon-

scious

3. Some Constructive Features of the Con-

cept OF Sin

4. "Sin," The Lesser of Two Evils

5. Judgment and Suffering: Contrasting

Views

6. The New Challenge to Our Churches

AND Seminaries: I. A Question of Theory

7. The New Challenge to Our Churches

AND Seminaries: II. The Problem of Ac-
tion

8. Psychopathology and the Problem of

Guilt, Confession, and Expiation

9. Psychotherapy and the Problem of Val-

ues IN Historical Perspective or The
Devil and Psychopathology

10. Psychology, Theology, and the Social

Self

11. Protestant Christianity: I. Ambiguity and

Disaster

12. Protestant Christianity: II. Challenge and

Change

13. Footnotes to a Theory of Psychopathol-

ogy
Bibliography and Author Index
Subject Index

To

CRYSTAL MOWRER SMITH

and

GLADYS DURDEN COOK

with gratitude for their faith in
the ultimate unity of psychology and religion

I

Some Philosophical Problems
in Psychological Counseling*

This paper is centrally concerned with certain historical
md cultural dimensions of the crisis in psychiatry and
eligion. Academic psychology [particularly here in Amer-
ca) and Freudian psychoanalysis (an indigenous Euro-
pean movement) were both powerfully influenced by
he Darwinian conception of organic evolution, which
egarded mind as essentially an ''organ of adaptation.'*
This type of approach has, in some ways, been extremely
iseful. However, there are today signs of acute unrest in
ioth psychiatry and psychology. Personal disorganization
md psychopathology persist as great unsolved problems
n our time; and there is growing conviction that the
ninciples and conditions of biological adaptation and
urvival do not necessarily provide the understanding
ieeded for psychological survival. Human beings are
nore than mere bodies, organisms, physiological entities;
^hey are also persons. And personality, it seems, can be

\ * Previously published in the Journal of Counseling Psychol-
ogy, 1957, 4, 103-111; also read, under a different title ("A
i*ractical. Contemporary Aspect of the Mind-Body Problem"),
t the Eighth Annual Institute in Psychiatry and Neurology held,
jinder the auspices of the Veterans Administration, in North Lit-
le Rock, Arkansas (March, 1956). Between then and the
Ime of original publication, a number of other pertinent refer-
Tices came to the writer's attention and were listed, for the
eader's convenience, as follows: Blake (1955), Fingarette
'1955), Gallagher (1956), Hobbs (1956), Liften (1953),
ylaslow (1956), Roberts (1956), Schneiderman (1954), Sho-
,.en (1955, 1956), Waiters (1955), White (1952), and Wil-
[amson (1956). And to this list a comment was added, "Al-
hough these papers do not by any means all take the same
losition as does the present author, they are unanimous in
ailing for a re-appraisal of the philosophical premises on which
ontemporary psychotherapy, counseling, and even diagnosis are
redicated."

2 The Crisis in Psychiatry and Religion

' properly understood and appreciated only in terms of
sociality, i.e., interpersonal and moral values systems.

Religion is, of course, deeply concerned with man as
person and personality; and in their shifting percep-
tion of man-as-hody to man-as-person, psychology and
psychiatry find themselves looking again, with renewed
interest and respect, at religious precept and practice.
Whatever may he the incompatibility of religion and
these secular disciplines in the metaphysical realm, here,
in the study of personality in its social and ethical dimen-
sions, is a natural and favorable meeting place. Although
it is at present impossible to foresee how far the rap-
prochement of religion and psychiatry, broadly con-
ceived, will eventually go, here, manifestly, is the place
to start.

Is mind designed to serve the body or is body designed
to serve the mind? During the last half century, assent
has been so nearly universally given by psychologists to
the first of these possibilities that the alternative view
has hardly been considered at all.

But there are signs that all is not well with psychology,
either as science or as profession, and that we may need
to re-examine some of our most basic assumptions. Ask
a representative sample of bright, young clinical psychol-
ogists who got their doctorate degrees at our best uni-
versities four or five years ago and who have since been
on the clinical firing line, ask them what they now think
of their training in light of their attempts to make appli-
cation thereof. Without bitterness, self-pity, or even
undue pessimism, they commonly express doubts of the
most profound and far-reaching nature. They question
both the instruments and the categories of diagnosis;
they feel that the rationale and results of psychotherapy
and counseling are uncertain; and they divergently evalu-
ate the significance of recent contributions to psychology
as a science.

Or, listen to what some of our elder statesmen have
to say in this connection. In 1955 the American Psychi-
atric Association sponsored an all-day symposium, by
psychiatrists and psychologists, on psychotherapy— later
published in book form under the title. Progress in Psy-

Philosophical Problems in Counseling 3

chotherapy (Fromm-Reichmann and Moreno, 1956).
Here are some of the comments made on this occasion:

Psychiatry has a great need for a clear and rational
understanding of the process of recovery. . . . Hypotheses
we have, . . . but none has gained that degree of validation
which should serve to command general acceptance in the
medical profession as a well-established theory (Whitehorn,
p. 62).

Psychotherapy has many more variants than psychoanalysis
and what constitutes psychotherapy, and what does not, is
even less clear than what is, or is not, psychoanalysis. . . .
The time has come to investigate not the differences but the
similarities, and to formulate common denominators among
the bewildering array of different methods and procedures
(Hoch, pp. 72-73).

It is discontent which drives me in my approach to this
problem. Only a few years ago (although it seems a long
time in my life as a psychoanalyst) I harbored the comfort-
ing expectation that increasing analytic sophistication and
experience would yield a higher percentage of therapeutic
successes. . . . My reluctant impression is that this hope
has not been realized (p. 87). I am impatient with any
propagandish approach to the problem from any point of
view. We have no right to be for or against anything in
this field. We have a right only to the most complete
humility — humility that says we still know practically nothing
about many important elements either in the neurotic process
or in the psychotherapeutic process) (Kubie, p. 101).

Psychotherapy is today in a state of disarray, almost ex-
actly as it was two hundred years ago (p. 108). At this stage
we seem to be fighting each other to attain some sort of
theoretic throne, and we often forget that that throne is as
unsteady as a three-legged chair (Zilboorg, p. 110).

Or, take still a different sort of evidence that we have
failed to meet manifest social need in this connection.
One of the most remarkable and unanticipated develop-
ments on the whole contemporary human scene is the
extent to which religious leaders are thinking about and
actively working at the problem of personality disorder.
Books on religion and pastoral counseling are being pub-
lished at an unprecedented rate, and if one takes the
trouble to examine them, one finds that they are some-
times quite thoughtful, informed, and creative. "Men-
tal Health" is a common pulpit topic; and to the twin

4 The Crisis in Psychiatry and Religion

concepts of "Sin and Salvation" has been added, "and
Sanity." Moreover, and even more remarkable, it seems
that the profession of psychiatry is now beginning to
think in a new way about the role of religion in mental
health and illness: witness the just-published books by
Viktor Frankl of Vienna (1953) and by the English
psychiatrist, Ernest White (1955). For similar trends
in this country, see The Church and Mental Health
(Maves, 1953) and Ministry and Medicine in Human
Relations (Galdston, 1955). And the same trend is also
conspicuous in Progress in Psychotherapy (Fromm-Reich-
mann and Moreno, 1956).

Granted, then, the reality of psychology's ailment,
what precisely is the diagnosis, what the remedy?

THE "biologizing" OF AMERICAN PSYCHOLOGY

The writer has just read Boring's paper (1950) on
"The Influence of Evolutionary Theory upon American
Psychological Thought." It is most suggestive. Boring
begins by noting a paradox, that in the latter part of the
nineteenth century, American psychologists were busy
ostensibly imitating and importing one kind of psy-
chology from Germany while, almost unwittingly, creat-
ing something very different. This was Functionalism
and, a little later. Behaviorism. Here Darwinian thought
was the touchstone. Says Boring:

To his thinking about psychology Dewey brought the con-
cept of functional use for the events of the mind, and thus,
closely related to functional use, the notion of functional
/activity. The way to express this matter is to say that both
I consciousness and activity function for the organism — the
luse of consciousness is to produce activity which "saves" the
organism. That is the essential tenet of the Chicago school of
functional psychology which Dewey started, and which An-
gell carried on. In the doctrine of this school behavior and
physiology and conscious states are mixed in with each other
because they are unified, not by their essential natures, but
by their common aim for the survival and use of the
organism (p. 277).

Boring then goes on to say that, in his judgment
(Watson to the contrary). Behaviorism was a direct
outgrowth "of Dewey's functionalism and of Cattell's

Philosophical Problems in Counseling 5

capacity psychology. . . . Watson's view was essentially
American, a psychology consistent with the [pioneer and
democratic] belief in necessity of struggle for survival"
p. 288).

Radical Behaviorism is today antiquated, on two scores,
(a) Its adherents, in the pursuit of their own objectives,
have found it increasingly necessary to make use of
"intervening variables." And (b) the spread of interest
in clinical psychology has, again of necessity, focused
interest upon mind rather than upon body, upon dis-
turbances of consciousness rather than upon questions of
biological adaptation. As Boring observes:

Behaviorism was itself too unsophisticated to last. It has
now given place to positivism or operationism or whatever
one prefers to call the newest psychological objectivism. The
operationist argues that all the data of psychology, including
the data of consciousness, are to be defined by the operations
which are used to observe them. You can know nothing
more about mind than you can find in the evidence for the
existence of mind. This movement gets its sophistication
from the logical positivism of the Vienna Circle and from
the operational physics of P. W. Bridgman, but this is not
the place for its full consideration. It is sufficient here to
point out that the epistemology of operationism was already
implicit in the faiths of behaviorism, functional and capacity
psychology, the basic American psychological faith (p. 288).

It is not the purpose of the present paper to suggest
that this faith, this ''basic American psychological faith,"
has been completely misplaced or entirely unfruitful.
The present author (Mowrer, 1960a); has spent the
past several months reviewing the research and theoretical
literature to which this faith has given rise in the field
of learning; the results are undeniably impressive. The
question is whether this faith is as broad, as inclusive,
as far-reaching as it ought to be.

Functional psychology becomes the study of the organism
in use. Functional psychology is thus practical through and
through in the way that Darwin's theory was the greatest
practical theory of living that has ever been put forth (Boring,
1950, p. 277).

Here, then, is the crux of the issue. Is it indeed true
that mind is designed to serve the body (which is pre-
sumably what is meant here by "practicality")? Or is

6 The Crisis in Psychiatry and Religion

there a reciprocal relationship of some sort, in which the
body must become obedient, even subservient to mind?
One hesitates to ask this question because of its clearly
anachronistic ring. Religion has always insisted that soul
is more important than body, that the flesh should be sub-
jugated by the spirit. And the *'old psychology," against
which Functionalism and Behaviorism were so strenuously
— and not without reason — rebelling, was based upon
presuppositions closely akin to those of theology. Boring
calls attention to "the influence of seventeenth century
theology upon Descartes, an influence abetted by lan-
guage." In French Vame, he notes, may be interpreted
either as mind or soul, and the same is true of the Ger-
man word, Seele. Since one does not attribute a *'soul"
to animals, there was, then, a tendency to deprive them
of "mind" (and consciousness) as well.

The Darwinian theory, on the contrary, asserted the exist-
ence of continuity between man and animals, continuity in
all respects, mental as well as physical, since man is believed
to be derived from animals by continuous change (Boring,
1950, pp. 284-285).

There is no doubt that much has been accomplished
by the Darwinian, the organic, the mechanistic approach
to mind. Many things of a psychological nature are now
clearly and systematically understood in objective terms
which were simply given, seemingly unanalyzable, in a
psychology which made conscious experience all impor-
tant. And with the physical models and thought forms
provided by modern servo theory, it seems that we have
by no means yet fully exploited or exhausted what can
be done along these lines. But we must return to the
thesis that all is not well with contemporary psychological
science. To assume otherwise, in face of the manifest
realities, is hazardous — and a betrayal of the ideals of
science itself.

BIOLOGICAL VERSUS PSYCHOLOGICAL SURVIVAL

The fact, the decidedly inconvenient but seemingly
inescapable fact, is that man must be concerned with
the struggle for psychological survival, as well as with

Philosophical Problems in Counseling 7

physical, organic, bodily survival. Indeed, he has already
succeeded so well in the latter respect that his very
success now constitutes one of our most pressing dilem-
mas (waning natural resources and a world population
that is increasing at the net rate of 75,000 persons per
day) [cf. also Chapter 13]. But in the struggle for^
psychological survival, we seem to be groping for first
principles. Whether, in absolute terms, there is more
"mental disease" in this country than formerly is perhaps
open to question; but relatively — relative, that is, to
physical illness and incapacity — psychological and emo-
tional disorders are so clearly in the lead that it is now
trite to refer to them as "the nation's number-one health
problem,'' the plague of modern times.

We have remarked upon the considered skepticism
and disillusionment of our bright young men in clinical
psychology. And we have also seen what some of our
more mature writers have to say about the field of
psychotherapy. Moreover, under the urgency of the grow-
ing popular demand that "something must be done,"
men in positions of responsibility and public trust have
openly declared that if a new "breakthrough" does not
soon come in the field of mental health, they will be
forced, by the very nature of their social obligations,
to start supporting research and training outside the
acknowledged professions of psychiatry, clinical psychol-
ogy, social work, and psychiatric nursing — not, perhaps,
with much conviction but out of sheer desperation.^

The professions just mentioned have, by and large,
pinned their hopes to psychoanalysis. This body of theory
and practice needs no criticism here; the logic of events
seems to be making purely verbal objections gratuitous.
While the present writer has previously joined in the
attack upon psychoanalysis, he now has no zest for further
criticism. If one can correctly interpret the course of
on-going developments, they clearly signify the failure

^ Since the above was written, the National Institute of Men-
tal Health (of the U. S. Public Health Service) has approved
several "pilot study" grants for training of personnel in psy-
chopharmacology, neurophysiology, sociology, theology, and
other "peripheral" professions. Note also the work of the newly
established Joint Commission on Mental Illness and Health.

8 The Crisis in Psychiatry and Religion

of this movement, leaving one only to say, perhaps,
''More's the pity. Things would have been so much
simpler, so much easier if Freud had only been right!"
But if reality is not as he thought, then the sooner and
more completely we recognize his errors the better.
/j We need hardly remind ourselves that Freud was
!*/ strongly influenced by the same forces that shaped the
"new psychology" in America. We know, by his own
repeated statement, that as a youth Freud read and
greatly admired Darwin, and the influence is evident:
for Freud, neurosis was the result of cultural (moral,
religious) interference with normal physiological (in-
stinctual) processes. The mind, if dominated by certain
mistaken social values, may cease to serve the body and
I obstruct its functions. The body then protests and
I retaliates. T/icrt is ''neurosis," and the crux of Freudian
\ psychopathology. Here we see Functionalism and Scien-
' tific Materialism applied to Twentieth-Century man's
most pressing problem. Are they indeed so eminently
\;j practical? Are they really the greatest ''theory of living
that has ever been set forth"?

Let us not sell them short. Functionalism and Scien-
tific Materialism provided the intellectual climate and
basic premises which have made possible unprecedented
advances in our knowledge of animal behavior and have
laid the foundation for attacking some distinctively
human problems — for example, the psychology of lan-
guage — ^with new insights and confidence (Mowrer,
1960b). Perhaps we merely lack patience. Give them
time and opportunity to demonstrate their ultimate
potency. Indirect report has it that one of the few re-
maining extreme Behaviorists has recently begun re-
searches with severely disturbed psychiatric patients and
that the therapeutic results already obtained are remark-
able. All power to this project. But sanguine hopes were
expressed decades ago for what the New Psychology
would do for the field of mental hygiene (Angell, 1907).
It has not, sad to say, borne the hoped-for fruit. Let no
hunch go neglected here. But neither history nor the
contemporary scene provides grounds for much confidence
that the solution, if solution there be, lies in that direc-
tion.
What other alternatives are there?

Philosophical Problems in Counseling

rHE NEED FOR A TRULY MENTAL HYGIENE

Is it, then, improper to explore the possibility that the
body must serve the mind, as well as mind serve the
body? While mind presumably evolved because, as Boring
^serves, it ''saves" the body, yet once evolved it appears
that mind has it s_owrispecial needs, its own conditions
[oT_jm}D^ii2l^.Jts_joym^^^g^ culture. And we must

then ask, How and inwhaFsense the body can serve and
"save" the mind?

For psychologists, this is a dangerous question to
consider; for if it is answered at all affirmatively — if we
Donclude that body must serve mind, it brings us imme-
diately into a domain where we are by no means authori-
ties, but rank amateurs. Religion has steadfastly said,
save in its weaker moments, that conduct must be guided
by the needs of the spirit as well as those of the body.
/\nd some of the best minds of all ages have devoted
themselves to working out patterns and precepts of con-
duct which are "holy" (integrative, redemptive, health-
giving, therapeutic). Here, not only are we psychologists
relatively uninformed; we have sat, alas, in the seat of
scorn and have barriers of pride and deep bias to over-
come before we can become even apt students, much
less teachers and trustworthy leaders in this area.

Let it be at once granted that religion has sometimes
taken an extreme and indefensible position in this con-
nection. Sometimes it has said that not only must the
body be subservient to mind and soul; the body must
also be despised and continually chastized. No greater
or more clarion voice ever cried out against this perver-
sion than that of Martin Luther. Said he:

No Christian should despise his position and life if he is
living in accordance with the word of God, but should say, "I
believe in Jesus Christ, and do so as the ten commandments
teach, and pray that our dear Lord God may help me thus
to do." That is a right holy life, and cannot be made holier
even if one fast himself to death. . . .

Huss has been burned, but not the truth with him (Stuber,
1952, p. 213).

Although Luther successfully launched the Protestant
Reformation, the philosophy of asceticism is still alive

10 The Crisis in Psychiatry and Religion

within but under debate by the Roman Church. Gold-
brunner (1955), an ordained priest and scholar well
known in Europe, has recently stated the growing senti-
ment within the Church against asceticism, in a most
interesting and energetic manner. But we need not here
pursue his argument in detail. Asceticism is clearly in
retreat. Moreover, it is not indigenous to or an intrinsic
part of the Christian *Vay" or life style. The founder
of the movement did not say, Do not eat at all. He even
taught his students and followers to give thanks for their
"daily bread.'* But he did insist that man does not live
by bread alone. And he spoke of a more abundant life, a
life of the spirit, which was to be achieved by relatedness,
reconciliation, fellowship — with man and God. What
^ does it profit a man, he asked, if he gain the whole
^ world but lose his mind, his soul? Truly a life with a
permanently disordered mind ("unredeemed soul") is a
^--"life worse than death." In insanity there is physical,
^"biological survival; a compassionate society sees to that.
^' But to what avail?

^ It has been common for us objectivists to psychologize
^ religion, to write about the "psychology of religion."
And Freud (1928), as we know, went a step further
and reduced it to a form of psychopathology, often
relatively benign but sometimes thoroughly malignant.
•^/TIow helpful, how constructive, how genuinely scientific
J have such forays been? Psychoanalysis as a movement
;| is in trouble. Church attendance in this country, by
7 contrast, is rapidly increasing, well beyond population
/ growth. In other words, Freud's "reality principle" ap-
pears to be doing less well than the "illusion" with such
an unpromising future. Perhaps Freud was still, in one
sense, right: maybe he was wrong only in his estimate
of man's growing capacity to live without illusion. Or,
can it be that he himself misperceived "reality"?

Under the sway of Darwinian thought, we practical,
functional, behavioristic psychologists have tended to
dismiss religion as irrelevant to both the scientific and
human enterprise, or, with Freud, to regard it as actively
inimical to soundness of body and mind alike. We have
analyzed, psychologized, pathologized religion, ignoring
the possibility that it is, in and of itself, a psychology,
souMogy of the profoundest sort. By our own stated

Philosophical Problems in Counseling 11

premises, our science is a species, a derivative of biology,
physiology, even physics. Religion represents man's at-
tempt, through the ages, to meet mind on its own terms.
Can this be a truer, more genuine psychology than our
own?

How to decide? The antiquity and continued vitality
of religious thought and action may be said to bear upon
the question. Freud argued to the contrary. It was some-
thing, he said, that had simply become lodged, adven-
titiously, in man's "unconscious" and was perpetuated
like some congenital physical weakness or disorder. But
contemporaneous, as well as historical, evidence suggests
that religion, as an institution, has survived for the reason
that it often has unique psychological survival value for
the individual. That it gave early Christians the capacity
to handle not only the ordinary conflicts and tensions
of life but enabled them to persevere in the face of and
eventually to overcome the most powerful political op-
position on the face of the earth is established history.
And in our own time the evidence from case-histories
of "brain washing" successfully withstood on religious
grounds is steadily growing (see, for example, Perkins,
1956).

The English psychiatrist, Ernest White, (1955, p. H)
takes this position:

One often finds that questions do not admit of a clear
answer because the assumptions on which they rest are false.
For example, after an address had been given on the subject
of Psychology and Religion, a member of the audience asked
why it was that so many more neurotic people were found
inside the churches as compared with people outside. Now
it is not possible to answer such a question unless it has
been first demonstrated by special investigation that there
are in fact more neurotics in proportion among churchgoers
than among the general population. As far as I know, no
such investigation has been made.

Preliminary attempts, apparently not known to White,
have been made in this country to get empirical evidence
on this point, with results that give church members
a comparatively clean bill of emotional health (Link,
1936, Chap. 1 and p. 99). But much more searching
study of the issue, at the empirical level, is obviously
needed. From one point of view, no neurotic individuals

12 The Crisis in Psychiatry and Religion

at all should be found in a church-going population. If
religion offers an assured salvation, this might seem to
follow axiomatically. But it would be absurd to condemn
hospitals, as institutions of physical remediation, because
one finds so many sick people in them. The appeal of
religious institutions has always been addressed to "poor,
sick souls," and Christ himself said that he did not come
to call the righteous. Hence, a study which would be
faithful to both sides of the argument needs to be care-
fully interpreted, as well as meticulously impartial.

COMMON ground: the study of interpersonal

AND GROUP RELATIONSHIPS

It has already been noted that psychologists, for reasons
given, have been hard to interest in religious psychology,
as opposed to objective psychology and psychoanalysis.
Indeed, as Roberts (1956) has observed, "A psycholo- j
gist who is suspected of being religious is at once under
suspicion of scientific incompetence," although the same
suspicion does not attach itself to a physicist, a chemist,
or an engineer. But there are signs of change. A number
of national organizations (typified by the National Acad-
emy of Religion and Mental Health ) have recently sprung
up with the avowed purpose of unifying, or at least, j
relating, psychology, psychiatry, and religion; and, within i
the American Psychological Association itself, there is s
now a "special interest group" in this area which has
held meetings at our two most recent conventions.

Perhaps most auspicious of all is the fact that so many
psychologists are now turning their research interests
toward problems which have long been of concern to
religious and church leaders, notably problems having
to do with social affiliation and what Foote and Cottrell
(1955) have aptly termed interpersonal competence.
Here it is inevitable that psychologists should encounter
many of the same realities as have interested religious
thinkers and practitioners throughout history. This point
is well illustrated in a paper recently published by Corsini i
and Rosenberg (1955). These writers did a sort of in- '
formal factor analysis of the contents of some 300 con-

Philosophical Problems in Counseling 13

temporary books and articles on the subject of group
psychotherapy and emerged with "ten classes of mechan-
isms" commonly emphasized therein.

All of these mechanisms, or principles, need not be
considered here; but the two which head Corsini and
Rosenberg's list are these:

Acceptance. This statistically most frequent concept was
taken to mean respect for and sympathy with the individual.
Acceptance implies belongingness, a warm, friendly, com-
fortable feeling in the group.

Altruism. Closely related to acceptance but in addition in-
volving wanting to do something for others is the mechanism
of altruism. The essence of this mechanism is the desire to
|help others (p. 107).

re these two mechanisms so salient because the
au^ors of the works thus analyzed have a basically
religious orientation? Or have the authors, with an
initially neutral or perhaps even unsympathetic attitude,
empirically rediscovered the therapeutic potency of ''fel-
lowship" and "charity"?

Whatever the answer to this question, the fact stands
out that, increasingly, psychologists are joining psychia-
trists and clergymen in looking for both the cause and
cure of personality difficulties in the social, interpersonal,
moral, or "spiritual" realm. But what of those most
welcome advances recently made in drug therapy? As
May (1955) has cogently observed, these drugs — merciful
as they are for use with persons in terror states and agita-
tions — leave essentially untouched the problem of pre-
vention and personality reorganization.

In our neighbor discipline. Sociology, there has long
been a tendency to view mind, or "self," as much more
of a social than biological phenomenon. Here the influ-
ence of Mead (1934) is already strong, and becoming
increasingly so. Thus the confluence of thought noted
above gains yet another tributary.

The centrality of religious tradition and practice is
obvious here. But there was a manifest difficulty. Let one
highly placed within organized religion, itself, speak on
this score. Says Rev. James A. Pike (1954), Dean of the
Episcopal Cathedral of St. John the Divine, in New
York:

14 The Crisis in Psychiatry and Religion

The Biblical writers are, by and large, short on concepts,
long on concern as to the human situation. The early Church
carried this tradition forward: the articles of the Creeds are
not just intellectual speculations. They are affirmations
wrought out in the fire of personal and corporate experience
and found to be abiding answers to perennial questions
which affect the nature and direction of human life under
God (p. 6).

The Biblical writers emphasize, not "theory," but
testimony. Make an "investment," "experiment," "try it"
say characters in Lloyd Douglas' novels. Or, in Pike's own
colorful phrase, in order to find out you have to "bet your
life." Prove all things, said the Apostle, Paul.^ Perhaps
psychologists can ultimately help provide a clearer, more
naturalistic, more rational explanation and understanding
of these pragmatic varieties. This would be an undertak-
ing of first-rate importance and magnitude. But before
psychologists and religionists can thus creatively collab-
orate, both must change from what they have earlier
been. Contemporary religious writers now seem increas-
ingly aware of errors into which religion fell during the
nineteenth century. One of these errors was obstinacy in
accepting the clear evidence for organic evolution. But
ever more grievous, perhaps, was a later willingness to go
too far in accepting the psychological view of man
seemingly dictated by evolutionary considerations. In the
introduction to Alexander Miller's recent book, The
Renewal of Man, Reinhold Niebuhr (1955) has said:

Christianity has tried rather too desperately to accom-
modate itself to modernity. In its desperation it frequently
sacrificed just those points in the Christian Gospel which
would throw light on mysteries which modern learning left
obscure (p. 8).

The present age, though incredulous toward the chief af-
firmations of this faith, is bound to find it more relevant
than previous ages, which conceived their own schemes of
salvation. Our age is the inheritor of the confusion and the
evil which proceeded precisely from these schemes of salva-
tion (p. 9).

'^Walters (1955) has pertinently observed that Freud,
while condemning religion, took the same position in
holding that no one could properly evaluate or criticize
psychoanalysis who had not himself had such an expe-
rience.

Philosophical Problems in Counseling 15

There are many indications, over and beyond those
cited in this paper, that we are now well into a religious
reformation comparable in scope and significance to that
of four hundred years ago. Institutionalized religion had
stagnated. Within the past century, science in general
and biological science in particular, threatened its very
life. Now religion appears to be recovering and, in that
process, has gained new vitality and validity. What are
the implications of this unexpected turn of events for
psychology? Although we may feel uncertain of the
answer, we cannot complacently ignore the question.

^

SUMMARY

There is clear indication that the theory of organic evo-
lution has profoundly and pervasively influenced American
psychology during the past three-quarters of a century.
Mind, rather than being something to be studied in its
own right, has been conceived as "an organ of adapta-
tion," an appendage of the body instrumental to the
achievement of bodily ends.

Thanks to the stance of the "New Psychology" (Func-
tionalism. Behaviorism), it has proved possible, for the
first time, to develop a systematic, essentially objective
understanding of many basic psychological processes.
Behavior theory is now a relatively unified assembly of
fact and principle which commands respect in any scien-
tific company.

Nor was the influence of Darwinian thought restricted
to psychology in this country. Equally potent was its
impact upon Freud and the school of psychopathology
which he founded. Here the "neuroses," both mild and
severe, were seen as springing from the fact that the
mind, under the sway of unfortunate or misdirected
social experience, has, in effect, turned against the body
and is no longer ministering to its needs.

But there is increasing evidence that neither the
original Freudian formulation nor its attempted restate-
ment in terms of contemporary behavior theory gives us
the answer to some of man's most profound, and uniquely
human, problems. Today we are probing the future
(through research) and searching the past, through
historical studies, for leads to a better and psychologically

16 The Crisis in Psychiatry and Religion

more abundant life. What do we find? Growing indica-
tion that the human mind, in its towering complexity^
long ago reached the point where it has its own special
conditions for ''survival/' conditions which are not only
different from those of physical comfort and well-being
but which may on occasion be in conflict therewith.
Both ongoing researches and a re-examination of history
point to the conclusion that religious precepts and prac-
tices, over the centuries, have grown up largely in response
to man's unique psychological needs and that there are
insights and prescriptions for action here which con-
temporary man may, with profit, reconsider.

Such a reconsideration seems now to be well under
way, mainly by theologians, naturally enough, but also,
and to a surprising degree, by psychiatrists. Psychologists,
in their increasing interest in group psychotherapy, are
also showing a new awareness of social values; and several
interprofessional groups have recently been formed for a
concerted confrontation of the problem at the level of
research and practice.

The burden of the present paper is that it will greatly
hasten this readjustment if we can succeed in seeing the
proper relationship between man's needs for physical
and psychological survival and can transcend the tacit
assumption that mind is merely servant of the body and
that, if it serves this master well, it will itself neces-
sarily prosper. Long ago we were reminded that man
does not live by bread alone; and it is none too early
for us to turn our attention to the identification and
better understanding of this ''something more."

Changing Conceptions
of the Unconscious*

Perhaps more than anything else, the feature of Freud-
ian psychoanalysis which has given it an air of mystery
and its practitioners a presumption of esoteric knowledge
and power is its doctrine of ''The Unconscious." In the
present chapter we see that this doctrine is in process of
radical revision and re-evaluation, along lines more con-
genial to common sense and traditional moral and reli-
gious ideology. Now it is possible, in terms of this evolv-
ing conception of psychopathology, for the average per-
son not only to know something about such matters but
also to do something, i.e., take initiative and responsibility
in their prevention and correction.

In the preceding chapter, we have postulated that per-
sonality disturbance can be adequately understood only
in an interpersonal, social, moral matrix. But in order for
this conception to hold, we must also be able to account
for the purely internal, intrapsychic — as well as external,
interpersonal — phenomena which characterize those
states we call neurosis and psychosis. The critical con-
sideration here is the way in which that remarkable
agency known as conscience operates. If our present
analysis is correct, personality disturbance is less an ''ill-
ness'' than an effort, on the part of "The Unconscious,"
to bring about personal change and growth. Can it be
that much of our current therapeutic and preventive
endeavor in this area is ineffective {even harmful) be-
cause it is predicated on a contrary set of assumptions?

INTRODUCTION

In a field which otherwise abounds with confusion and
uncertainty, there is one rock-ribbed fact: namely, that
the hallmark of psychopathology is a feeling, on the part
of the afflicted individual, that he is having experiences

17

18 The Crisis in Psychiatry and Religion

which he himself did not plan or "will" and which he
does not at all understand. The ubiquity of this observa-
tion, therefore, makes entirely plausible the impression
that personality disturbance is somehow associated with
the presence and activity of an alien, dissociated, un-
known, and ominous force or set of forces within the
personality which is currently known as The Unconscious, j
But beyond this point, there is scant agreement. What
is in the Unconscious? How did it get there? What is it
trying to do? Should it be assisted or opposed? These
are questions to which, in our time, we have had no
assured answers. The purpose of the present paper is to
look at these questions and at the overall problem of psy-
chopathology in historical perspective and to suggest, ten-
tatively, a way of reinterpreting and, hopefully, integrat-
ing the presently discordant array of fact, theory, and
practice.

FREUD ON REPRESSION AND THE UNCONSCIOUS

From the point of view of this inquiry, 1915 was an
eventful year. In that year Freud published two papers,
one on ''Repression" and the other on 'The Uncon-
scious" which epitomized his theoretical system or so-
called "metapsychology" and which set forth ideas that
have gained world-wide currency and influence. In the
second of these papers, Freud argued persuasively that
the concept of mind or mental activity should not be
confined to those processess which are at any given mo-
ment conscious or likely to become conscious, but should
instead include forces or processes which are unconscious
but which are not, for that reason, to be thought of as
dormant or ineffectual in determining experience and
action. He said:

In many quarters our justification is disputed for assuming
the existence of an unconscious system in the mind and
for employing such an assumption for purposes of scientific
work. To this we can reply that our assumption of the
existence of the unconscious is necessary and legitimate, and

* Prepared and delivered, by invitation, as a lecture at the
1958 meeting of the American Personnel and Guidance Asso-
ciation, in St. Louis, and subsequently published in The Jour-
nal of Nervous and Mental Diseases, 1959, 129, 222-232.

Changing Conceptions of the Unconscious 19

that we possess manifold proofs of the existence of the un-
conscious. It is necessary because the data of consciousness
are exceedingly defective; both in healthy and in sick persons
mental acts are often in process which can be explained only
by presupposing other acts, of which consciousness yields no
evidence. These include not only the parapraxes and dreams
of healthy persons, and everything designated a mental
symptom or an obsession in the sick; our most intimate daily
experience introduces us to sudden ideas of the source of
which we are ignorant, and to results of mentation arrived at
we know not how. All these conscious acts remain discon-
nected and unintelligible if we are determined to hold fast
to the claim that every single mental act performed within
us must be consciously experienced; on the other hand, they
fall into a demonstrable connection if we interpolate the
unconscious acts that we infer. . . . We become obliged
then to take up the position that it is both untenable and
presumpfeious to claim that whatever goes on in the mind
must be known to consciousness (1915b, p. 99).

While Freud did not hold that the unconscious mind
is created solely by repression, he did hold that repression
is a potent source of unconscious energies and a prime
cause of psychopathology. The mere fact that an idea
or impulse has been banished from consciousness does
not at all mean that it has lost its dynamic properties;
and its continued striving for recognition and expression
constitutes, according to Freud, the principal basis of
anxiety and ensuing symptom formation. More specifically
Freud believed that the mental processes which are most
likely to undergo repression are the instinctual forces of
sexuality and hostility and that repression occurs, typi-
cally, v^^hen the ego, under the sway of socially instilled
moral precepts, rejects and condemns these impulses.

Two forms or stages of repression were to be distin-
guished. There was, first of all, what Freud called primal
repression^ *'a first phase of repression, which consists in
a denial of entry into conscious of the mental (idea-
tional) presentation of the instinct" (1915a, p. 86). But,
continued Freud, "repression does not hinder the instinct-
presentation from continuing to exist in the unconscious
and from organizing itself further, putting forth deriva-
tives and instituting connections" (p. 87).

The second phase of repression, repression proper, con-
cerns mental derivatives of the repressed instinct-presentation,

20 The Crisis in Psychiatry and Religion

or such trains of thought as, originating elsewhere, have
come into associative connection with it. On account of this
association, these ideas experience the same fate as that
which underwent primal repression. Repression proper, there-
fore, is actually an after-expulsion (pp. 86-87).

Therefore, continued Freud,

The process of repression is not to be regarded as some-
thing which takes place once for all, the results of which
are permanent, as when some living thing has been killed
and from that time onward is dead; on the contrary, repres-
sion demands a constant expenditure of energy, and if this
were discontinued the success of the repression would be
jeopardized, so that a fresh act of repression would be neces-
sary. We may imagine that what is repressed exercises a con-
tinuous straining in the direction of consciousness, so that the
balance has to be kept by means of a steady counter-pressure.
A constant expenditure of energy, therefore, is entailed in 1
maintaining a repression, and economically its abrogation
denotes a saving (pp. 89-90).

The resolution of a conflict between instinct and moral
scruple by means of repression is thus unstable and debil- ^
itating; and from this it followed, reasonably enough,
that the sovereign aim of therapy was to undo repression
and permit sexual and hostile impulses to find freer, less
encumbered routes to gratification. Such a program called
upon the psychoanalyst to align himself with and to speak
for the instincts, in opposition to the moral or pseudo-
moral forces within the personality which have instituted
the repression. Hopefully, these forces can be held back
by the combined strength of the patient and the analyst
so that the blocked instincts can find more adequate ex-
pression; and, more than this, it was believed that, by
working through the so-called transference neurosis, the
severity and irrationality of these forces might be perma-
nently lessened so that, following analysis, the individual
could function, more naturally and more comfortably,
without the analyst's continued presence or assistance.

For all practical purposes, Freud's theory was here-
with complete. In the 1915 papers he still regarded anx-
iety as a direct "transformation" of the repressed im-
pulses, a view which was to be somewhat modified in his
"second theory" of anxiety. And he was still to introduce
the term, superego, although he was already speaking of a

Changing Conceptions of the Unconscious 21

"censorship" function (1915b, p. 105). But, in broad
outline at least, the theory was fully developed and was
later to be changed in only minor ways. With his special
gift for graphic similes, Freud summarized his discussion
of repression thus:

In general, repression of an instinct can surely only have
the effect of causing it to vanish from consciousness if it had
previously been in consciousness, or of holding it back if it
is about to enter it. The difference, after all, is not impor-
tant; it amounts to much the same thing as the difference
between ordering an undesirable guest out of my drawing-
room or out of my front hall, and refusing to let him cross
my threshold once I have recognized him (1915a, p. 91).

To which we need only add that the unwelcome
"guest" does not, after his ejection, quietly go away, but
instead continues to try to find other means of re-entry
and, much in the manner of a restless ghost, haunts the
abode which it feels to be rightfully its own, to the dis-
may and discomfiture of the dominant occupant.

THE^ ALTERNATIVE VIEW

OF STEKEL, BOISEN AND OTHERS

In his recently published three-volume biography,
Ernest Jones defends Freud against the common surmise
that he was a difficult man to get along with and argues
that those who were first attracted to but then, sooner or
later, turned against him were themselves unstable or of
doubtful character. On the other hand, Ira Progoff, in
his book The Death and Rebirth of Psychology, suggests
that the difficulty was not basically one of ''personality"
at all, on either side, but was rather ideological. At least
in the case of Adler, Jung and Rank the final rupture,
Progoff holds, came because these men were keenly aware
of incongruities between the clinical facts and Freud's
theories and were compelled to withdraw from the orbit
of his influence in order to be true to their own develop-
ing ideas and convictions [cf . Chapter 1 3] .

Among the less well known but most interesting of
those men who first joined and then left Freud was
Wilhelm Stekel. In his autobiography, published in 1950,
Stekel gives the details of his break with Freud, over ap-
parently personal and practical matters; but a study of

22 The Crisis in Psychiatry and Religion

StekeFs other published works reveals a deep and, for our
purposes, highly significant theoretical deviation.

In the preface of a book first published in German
(1938) and later translated into English (1950), with
the title Technique of Analytical Psychotherapy, Stekel
indicated just how complete his break with Freud had
been by remarking:

I contend that orthodox analysis has reached a crisis which
betokens that the end is near, that collapse is approaching.
Clinical records of its successes count for nothing, now. The
happy days of interminable analyses are gone for ever (p.
xxii ) }

The medical analysis of tomorrow will have to separate
the wheat from the chaff, to combine the various doctrines
and schools into an organic whole, and to establish an un-
dogmatic, unprejudiced psychoanalysis. Then the physician
will become the educator of mankind (p. xxiv).

The seemingly hasty and bombastic way in which
Stekel wrote undoubtedly kept him from being taken as
seriously as he otherwise might have been; but in light of
subsequent developments, we find a genuinely prophetic
element in his work. In Technique of Analytical Psy-
chotherapy there is a most remarkable chapter entitled
''Diseases of the Conscience" which does not unfold at
all the way one might expect it to. Freud — implicitly in
his early writings and, later on, quite explicitly — ^held
that repression, as the primal pathogenic act, occurs be-
cause the individual's conscience or superego is too severe,
unrealistic, and irrational. Therefore, when Stekel refers
to "diseases of consciences," one might well expect him
to have in mind much the same assumptions as had
underlain Freud's conception of the so-called neuroses.

Instead, Stekel's attitude toward conscience is respectful
and positive; and by ''diseases of conscience" it is quickly
apparent that he means diseases or disturbances which
are caused by a careless disregard or active defiance of
conscience and its urgings. He says:

My experiences as a psychotherapist have convinced me
that many nervous disorders are "diseases of the conscience."
Of course it is far from easy to recognize conscience under

* Cf . Freud's own paper, "Analysis terminable and intermin-
able" (1937).

Changing Conceptions of the Unconscious 23

the manifold disguises it can assume. But there are stereo-
typed ways by which we can be aided in exposing the wiles
of conscience, and in discovering when parapaths are play-
acting — for they often persuade themselves that they have
no conscience, and take refuge in an ostensibly organic
disease in order to escape the torment of self-reproach. Some-
times, however, such a patient will during the analysis have
a bad "fit of conscience," bursting into tears, which may
continue for as much as half an hour before the releasing
avowal comes (p. 320).

Stekel, as was his literary practice, then plunges into a
series of interesting and highly dramatic case histories
which we cannot review here. But in summary he says:

All these cases show how grave a blunder we should make
were we to accept the one-sided view of those Freudians who
hold that lack of sexual gratification is the exclusive cause of
psychogenic troubles. In Cases 69, 70, and 71, free rein was
given to the sexual impulse, which was adequately gratified,
and yet intractable illness supervened, whereas during the
periods of abstinence the symptoms disappeared because the
conflict-engendering relations were broken off and the con-
science was at rest (p. 324).

I have had many cases of the kind, but have merely
selected a few to show that parapathic disorders may be
diseases of the conscience. The patient suppresses his re-
morse, tries to drown the voice of conscience, and feigns
immunity. Nature takes vengeance (p. 327).

As long as Freudian theory was in the ascendancy, it is
little wonder that Stekel's views remained unknown and
without influence. But in 1956 a book entitled Progress
in Psychotherapy was published in this country (under
the semi-official auspices of the American Psychiatric As-
sociation) in which many of the forty-odd contributors
expressed mounting doubt and disillusionment concern-
ing orthodox psychoanalysis and in which there is a
chapter, by Lowy and Gutheil, which is devoted to an ex-
position and advocacy of Stekel's so-called "active ana-
lytic" approach to psychotherapy. Here these authors say:

Stekel's debut as the originator of an independent psy-
choanalytic technique was manifested by his thesis that every
< neurosis — or as he called it "parapathy" — is based on a con-
Iflict between the principles of morality and loyalty and the
impulses and tendencies to the contrary. This simple, clini-

24 The Crisis in Psychiatry and Religion

cally evolved formula was then not as self-evident as it has
become subsequently. . . .

Although essentially a practitioner, Stekel also made a few
important contributions to the theory of psychoanalysis. Long
before Freud's discovery of the superego, Stekel spoke of the
-'moral ego" as a factor in the psychogenesis of neurosis. He
//maintained that a neurotic reaction can ensue not only
i through the repression of moral tendencies; that on certain
*• occasions, even if the individual appears to be ready to give
/ in to his antimoral and antisocial desires, the moral trends
I may assert themselves against the patient's will. He [Stekel]
quoted the case of a traveling salesman who was always
potent with his wife, while being impotent with other
women. Cases of this type were considered proofs that
neurotic symptoms may be serving the patient's unconscious
moral needs, that they may safeguard the individual's in-
trinsic morality (p. 136).

As ProgofI points out in the book previously cited,
Adler, Jung and Rank, in abandoning the classical psy-
choanalytic position, all moved in the direction of a
greater emphasis upon the social, moral, or ''spiritual"
factors in neurosis; but this trend was certainly outstand-
ing in Stekel, as the foregoing quotations indicate.

Also, about the same time and apparently quite inde-
pendently of any direct connection v^ith Stekel, an
American writer by the name of Anton T. Boisen was
formulating a very similar point of view. As a result of a
brief psychotic experience of his own and of subsequent
participation in the Rockefeller-supported study of schizo-
phrenia at the Worcester (Massachusetts) State Hos-
pital, Boisen became convinced that psychosis represents
a character crisis, from which an individual may move
either in the direction of deterioration or toward personal
reorganization on an ethically and socially higher plane.
Gentle, soft-spoken, and in no sense given to controversy,
Boisen was temperamentally very different from Stekel,
yet his ideas about psychopathology are much the same.
In his best known book. The Exploration of the Inner
World (1936), Boisen's views are epitomized by the fol-
lowing excerpts. He says:

The form of psychotherapy now most in the public eye is
psychoanalysis. This in its aims is the exact opposite of
faith healing. It has often been compared by its proponents
to surgery, and major surgery at that. It is an attempt to

Changing Conceptions of the Unconscious 25

lay bare and bring into clear consciousness the disowned
sexual desires and cravings which it assumes have become
detached from the conscious self and are responsible for the
neurotic symptoms. Its aim is to make over the harsh con-
science and the rigid ethical standards which have led to the
disowning of these sex cravings so as to permit of their in-
corporation in the personality. To this end the psychoanalyst
tries to get his patient to live through again his early ex-
periences. The entire procedure is designed to detach the
patient from his early loyalties in order to enable him to
build up a new philosophy of life in which the dissociated
cravings may be properly assimilated (pp. 243-244).

In all my efforts [as a hospital chaplain and therapist] I

rely upon a simple principle derived from my theological

training which seems to me far too little understood. I refer

jto the view that the real evil in mental disorder is not to be

\found in the conflict but in the sense of isolation or estrange-

\ment. It is the fear and guilt which result from the presence

iin one's life of that which one is afraid to tell.^ For this

reason I do not consider it necessary to lower the conscience

threshold in order to get rid of the conflict. What is needed

is forgiveness and restoration to the fellowship of that social

something which we call God (pp. 267-268).

I would furthermore [suggest] that our findings indicate
that the sense of guilt, the self-blame and the emotional dis-
turbance which accompany it are not themselves evils but
atteijipts at a cure. The real evil is the failure to attain the
level of adjustment called for in some new period of develop-
ment and the short-circuiting of the vital energies through
; easy satisfaction (p. 281).

Elsewhere in the same volume Boisen, using a phrase-
ilogy almost exactly the same as Stekel's, refers to a
everely neurotic or psychotic person as one who ''has
ecourse to certain unsatisfactory protective devices, seek-
ng to suppress a troublesome conscience, until the ten-
ion reaches the breaking point and the solution comes
i^ith cataclysmic suddenness" (p. 78).

Only vaguely aware of the names of Stekel and Boisen
nd without any detailed familiarity with their writings,
he present writer, in 1947, after more than a decade of
icceptance of the Freudian view, took the following posi-
ion:

^ Somewhere I have recently read that Havelock Ellis, even
:arlier, once remarked that the problem of psychopathology
irises, not from the unconscious, but from the unutteredl

26 The Crisis in Psychiatry and Religion

By way of recapitulation let it be said that we are here
fully accepting the basic theory of Freud concerning the na-
ture of symptom formation, i.e., that a neurotic symptom,
so-called, is any habit which resolves anxiety but does not ;
lessen the ultimate, realistic problem which the anxiety repre-
sents. And we are also in complete accord with Freud's con-
tention that repression is necessary to an adequate theory of
anxiety; without this concept a really satisfactory account of:'
anxiety is apparently quite impossible. But it now appears, onjl
both pragmatic and logical groups, that Freud never suc-
ceeded in fully apprehending the essential nature of anxiety '
itself.

It is not possible at this time to give at all completely the J
evidence on which this statement is based. But what can be;'
/ j indicated, at least briefly, is the direction in which Freud's
/ ! analysis needs to be modified. In essence, Freud's theory
holds that anxiety comes from evil wishes, from acts which ,
the individual would commit if he dared. The alternative
view here proposed is that anxiety comes, not from acts
which the individual would commit but dares not, but from
acts which he has committed but wishes that he had not. It
is, in other words, a ''guilt theory" of anxiety rather than an
"impulse theory."
^ Stated in its most concise but abstract form, the diflFerence

'^^ between these two views is that the one holds that anxiety
arises from repression that has been turned toward the id;
whereas the other holds that anxiety arises from repression,
that has been turned toward the superego or conscience (p.
537).

Naturally, the later discovery of the antecedent works
of Stekel and Boisen and the privilege of personal ac-
quaintance with Dr. Boisen have been a source of great
personal satisfaction to the writer. But, despite the con-
verging agreements to be found here and elsewhere in
contemporary literature, some conceptual difficulties are
still to be resolved. These, it so happens, have been
neatly summarized by Sidney M. Jourard in his book.
Personal Adjustment — An Approach Through the Study
of Healthy Personality. Here the author says:

Clinical experience suggests that neither Freud nor Mowrer
is wholly correct or wholly incorrect. Rather, it can be
found that some neurotic patients do indeed have a con-
science that is too strict; in order to remain guilt-free, they
must refrain from all pleasurable activities, including those
which society condones. Other patients may be found with

Changing Conceptions of the Unconscious 27

the makeup which Mowrer has regarded as nuclear to all
neurosis — they repress conscience so they can break social
tabooes without conscious guilt.

If we paraphrase Freud's therapeutic aim to read, "change
the conscience in lenient directions," and Mowrer's to read,
"strengthen the conscience, and help the person to conform
with his conscience," we are thrust into an acute impasse: we
find that contradictory roles are assigned to the conscience in
neurosis, and contradictory therapeutic aims are proposed.
This impasse can be resolved if we recognize that consciences
are not all alike among all members of a given society. Some
consciences are stricter than the society requires, some are
more lenient, some are quite deviant from the social value
system, and many are highly conflicted (p. 366).*

This analysis seems by no means unreasonable. It does
lot, however, accurately represent my own earlier posi-
:ion in these matters, in that never did I hold that it was
:he aim of therapy to strengthen or increase the severity
)f the conscience, although this has been a common
nispreception. All I had said was that perhaps the neuro-
:ic's great need was to have his conscience released^ just
IS Freud had conjectured that it was certain repressed
nstincts that were clamoring for freer access to con-
leiousness and a greater share in the control of behavior.
[n neither case was it suggested or even implied that the
repressed part of the personality needed to be strength-
zned. Because Freud did hold that the neurotic's superego
[leeded to be made less rigid and less severe; and because
[ had expressed a disagreement with this position, it was
m easy but entirely mistaken inference that I was saying
just the reverse of this. My difference with Freud's posi-
tion had to do, explicitly and exclusively, with the ques-
tion of what is repressed or, in other words, with the
direction of repression and the content of the uncon-
scious; and I welcome this opportunity to attempt to
clarify the issue (see Levitsky, 1960).

In other respects. Dr. Jourard's formulation is certainly
plausible. Consciences do vary, from infancy to maturity,
from culture to culture, and from individual to individual
within the same culture. The sociopath, at least by
definition if not in actual fact, is a person with an under-

*For a somewhat similar position, see Fenichel (1954),
Fromm (1947) and Jung (1938).

28 The Crisis in Psychiatry and Religion

developed, weak conscience; and there is certainly no rea-
son, a priori, why in other individuals conscience might
not be excessively severe. However, it is not my wish here
to debate this issue, either on empirical or logical grounds.
Rather do I wish to invite attention to a different way of
conceptualizing the whole matter of the unconscious,
conscience, and the question of repression.

THE UNCONSCIOUS RE-EXAMINED

IN A RELIGIOUS CONTEXT I

Psychologists, despite pretentions of open-mindedness
and scientific objectivity, have in certain respects been
an arrogant and bigoted lot. I recall hearing a colleague,
in the mid-19 30s, when the question of whether we
should include History in the disciplines represented at
the Institute of Human Relations at Yale, say that we
were not interested in History, that we were not inter-
ested even in the History of Science, that we were in-
terested only in making Science. And certainly there has
been a widespread assumption that the Future was ours
alone. Some of us psychologists are now old enough to
feel that we have experienced a sizeable piece of this
Future, and we are by no means sure that we are neces-
sarily much wiser or more efficient directors of destiny
than were some of our forebears. Certainly the phe-
nomena which we today call psychopathology have been
known to mankind for a very long time; and it is by nc
means certain that our progenitors understood or man-
aged them less well than do we.

Thus chastened, I, as a psychologist, have found mysell
looking with renewed interest and respect at some of the
great cultural and historical documents of the past; anc.
here I have found nothing more illuminating than thai
remarkable collection of writings known as the Ok
Testament. The language is often metaphorical anc
poetic; but the basic intent and content of these writing:
can hardly be missed. And here we find, unmistakably,
psychiatry which is at one with religion.

Old Testament writers interpreted their own and thei:
fellowmen's emotional anguish as a manifestation of th«
"wrath of Cod." This idea is found in Ecclesiastes (5
7), Isaiah (J 3, 9), Psalms (90), and elsewhere; and Jol

Changing Conceptions of the Unconscious 29

puts it succinctly when he says, ''Have pity upon me,
have pity upon me, O my friends; for the hand of God
hath touched me" (19, 21). But the theme is perhaps
most explicitly and fully developed, in the 4th Chapter of
Ist Daniel, in the account of the madness that beset
Nebuchadnezzar. Being afflicted by visions and dreams,
the King called Daniel in to interpret them for him. After
nuch hesitation, Daniel told the King that he had be-
:ome vain and iniquitous, and that he was going to have
;o suffer grieviously before he found deliverance.

And at the end of the days [of suffering and humiliation]
I Nebuchadnezzar lifted up mine eyes unto heaven, and
mine understanding returned unto me, and I blessed the
most High, and I praised and honoured him that liveth
forever, whose dominion is an everlasting dominion, and his
kingdom is from generation to generation; and all the in-
habitants of the earth are reputed as nothing: and he doeth
according to his will in the army of heaven, and among the
inhabitants of the earth: and none can stay his hand, or say
unto him. What doest thou?

At the same time my reason returned unto me; and for
the glory of my kingdom, mine honour and brightness re-
turned unto me; and my counsellors and my lords sought
unto me; and I was established in my kingdom; and excellent
majesty was added unto me.

Here, it seems, are implications of a most profound

md far-reaching kind. Here, if I understand the stories of

ob, Nebuchadnezzar, and other Old Testament charac-

ers, there is no intimation that psychopathology neces-

arily involves repression; surely the very core of the prob-

em is that God has spoken, expressed himself, touched

he individual in question. And there is accordingly no

ntention or need to make the unconscious conscious.*

rhe question rather is why God and conscience have

mitten us and what we can do about it.

This is not to say, of course, that the now afflicted in-

ividual may not have previously repressed conscience

nd "denied God." The wicked are often referred to as

hard of heart," calloused, and insensitive. And as long

*Cf. Stekel's remark, "After thirty years' experience of
Analysis, I no longer believe in the overwhelming significance
If the unconscious (in the Freudian sense of that term)"
!l938, p. xx).

30 The Crisis in Psychiatry and Religion

as these defenses hold, there is no manifest disturbance.
Rather the "disease," if we may now use that term in a
-Strictly social and moral sense, is to this point a purely
latent one; and when conscience finally rebels and erupts,
when, in Biblical language God's patience is exhausted,
the individual is already grappling with a crisis from which
he may emerge a chastened, changed, and converted
man [see also Chapter 9].

Of course, in a certain limited sense one may say that
religious leaders do attempt to make the unconscious con-
scious, do attempt to release repressed, imprisoned, de-
nied forces of personality. To the hard of heart, they con-
tinually put forth a ''call to repentance," the confession
of sin, and reaffirmation of obedience to the good and to
the godly. In fact, it would seem that this is one of the
main functions of regular worship on the part of the
devout, to constantly acknowledge and correct their way-
wardness and to grow in the "grace and admonition of
the Lord."

But it is surely equally, or even more importantly, true
that remorse, contrition, and dismay often break out
spontaneously in deviant individuals and that it is this
state of manifest disturbance which we call neurosis or
mental illness and which someone is supposed to "treat."
Therefore, it would seem to be a real question as tO;
whether efforts at making the unconscious conscious arei
relevant. If, by the unconscious, we now mean conscience!
and the "Hand of God," the task would seem to be
quite the reverse, namely that of helping the individual
find what he can do that will please God, satisfy con-
science, and thus allow him once more to "go forth in
peace."

Steeped as we are, in this generation, in a particulai
form of naturalism, we do not easily assimilate either th(
language or the thought forms of the ancient Hebrews
but if the interpretation of psychopathology which ha:
just been suggested be correct, its naturalistic basis is a-
once apparent. To me it has been helpful to recall tha-
a child can operate in either of two ways: (a) of his owi
free will and wish or (b) under parental compulsion. By
acting "like a big boy (or girl)," that is to say, maturely
and responsibly, the child enjoys many privileges and feel
and indeed is "free." But if the child "forgets" or ignore

Changing Conceptions of the Unconscious 31

ivhat his parents have tried to teach him, they have to
reassert their authority, with an ensuing loss of freedom
md self-direction on the part of the child.

In like manner, may we not assume that an adult is
:ree, i.e., self-determining and autonomous, only so long
is he is good and that when he sufficiently violates the
^rust of conscience, the latter ''takes over," perhaps far
from gently and almost certainly with a feeling on the
jjart of the individual that ''things are happening to me."
Like the parents of an earlier day, conscience thus de-
prives the individual of his freedom and will restore it
|)nly when he has shown that he can again be trusted,
rhus, the objective of therapy is not to "make the un-
;onscious conscious." If the view just indicated is valid,
:he very root of the difficulty is that the unconscious
[now understood as conscience) is all too much in evi-
ience — and the objective is to get it to subside, retreat,
elax; and this it will presumably do only when the ego
)r autonomous part of the personality has redeemed
tself.

I Religion, in its most vital and significant form, has
ilways been intent upon saving "lost souls," i.e., in help-
ng individuals regain their sense of peace and freedom
hrough a return to responsible living, integrity, and
:oncern and compassion for others. This, it seems, is
'therapy" of the most profound variety; and it is perhaps
lur great misfortune that this conception is today ac-
epted and practiced with so little confidence.

IMPLICATIONS FOR PSYCHOTHERAPY, COUNSELING,
AND "ego psychology"

I If space permitted, it would perhaps be profitable to
ry to relate the foregoing discussion to that somewhat
haotic but vigorously growing system of thought known
Is contemporary learning theory. Starting as it did with
list the two concepts of objectively observable stimula-
ion and response, learning theory has gradually incorpo-
ated certain subjective, or "intervening," variables, no-
ably those of fear, relief, hope, and disappointment. Karl
/[uenzinger, at the University of Colorado, has recently
uggested a way in which "courage" can be operationally
lefined and empirically studied in rats or other laboratory

32 The Crisis in Psychiatry and Religion

animals; and I think it entirely probable that learning
theory will soon be elaborated to the point that it can
be equally precise and explicit about the phenomenon of
guilt. Already some progress has been made in this con-
nection, but it would carry us too far afield to discuss this
matter further [cf. Mowrer, 1960b; 1961].

Recently I was much interested and, I confess, not a
little surprised to hear a physiological psychologist state
that there is some evidence that the neurological cor-
relates of the unconscious mind have now been at least
roughly identified and that there is apparently here a
capacity for gross emotional conditioning which may later
affect the individual in ways very similar to those already
attributed to conscience in this paper. Here, likewise, we
will await further developments eagerly, with the pos-
sibility in mind that we may, at long last, be approach-
ing a way of thinking about psychopathology which
articulates not only with social psychology and religion
but also with learning theory and neurophysiology.

But there is a more immediate consideration before
us. A few months ago I heard a theologian say that al-
though he was convinced that religion is relevant to the
problem of mental health, he did not regard religion asi
sufficient in this connection. When asked to elaborate,!
the theologian said that he meant, quite simply, that reli-
gion can deal with the conscious personality, but not
with unconscious forces. This position reflects, of course,
one way in which the church has tried to make peace
with the ^secular healing professions; but there is a ques-
tion as to whether such a ''division of labor" corresponds
to reality. If the line of thought we have pursued in this
paper is even remotely valid, religion, at its best, is always
concerned with the unconscious, conceived as conscience
and the Voice of God. The God of Moses was known as
the Invisible God, and the church, quite generally, has
been concerned with helping individuals live so that the}
do not see God as an hallucination or hear his angr)
voice.^

Now if our general point of view here is tenable, one
would have to entertain the same misgivings about th(

° See Boisen's illuminating discussion (1952) of the "ex
ternalization of conscience"; also Freud on the ''delusion o
observation" (1933, p. 85).

Changing Conceptions of the Unconscious 3B

attempt which is commonly made to draw a Hne between
psychological counseling and psychotherapy on the
grounds that the latter deals with unconscious material
whereas the former does not or at least should not. In
November, 1950, the University of Minnesota was host
to a conference on ''Concepts and Programs of Counsel-
ing"; and at that time I gave a paper entitled "Anxiety
Theory as a Basis for Distinguishing between Counseling
land Psychotherapy." Much of what was said on that oc-
jcasion is congruent with the present discussion. Take for
;example this sentence: "It makes an enormous difference
(practically whether we, as therapists, are afraid of anxiety
|in our patients (or in ourselves) [as something malignant
and destructive] or whether we see it as essentially a con-
structive ally both to our therapeutic efforts and to the
best trends and forces within the patient" (p. 26).

But I also took the position that we should clearly
distinguish between two forms of helping activity — call
them what you will — the one of which involves dealing
with essentially normal persons, i.e., persons whose con-
flicts and difficulties are still fully conscious, and the other
involving persons in whom dissociation and repression
have already occurred and where there is therefore an
unconscious to deal with. While such a distinction may
btill have a limited justification, it would now seem that
[the psychological counselor, at least in principle, is in
piuch the same position as the religious counselor. If our
easoning has been correct, the normal individual has
ictually a "larger" unconscious than does a disturbed per-
on; and support, direct admonition, and counsel may
)e one of the best means, in the latter case, to get con-
icience to relax and again become "unconscious." As al-
■eady suggested, the best way for a child to get his parents
'off his back," to use a common but graphic expression,
s for him to redeem himself with respect to past mis-
deeds and to regain their confidence and trust for the
[uture. Likewise, surely, the best hope of the conscience-
;tricken adult is to associate himself with other persons
)r ideas which can encourage and guide him into paths
)f conduct that will lead ultimately to the approval rather
han condemnation of conscience.

Today it is difficult to discern clearly what is happening
n the field of psychoanalysis. In general, it is in a state

34 The Crisis in Psychiatry and Religion

of crisis and uncertainty [cf . Chapter 1 3] . But one trend
stands out rather unmistakably, namely, the growing em-
phasis upon *'ego psychology." I cannot claim to have
been a close student of this trend, but even from afar
one sees in it developments which are complementary to
the thinking we are here exploring. Here, instead of stress-
ing superego over-severity, we find more reference to the
importance of ego adequacy. Here it is not nearly so much
a question, as it was formerly, of how to pare down or
reform the conscience; rather the question is, how to get
the conscious self-system or ego of the individual to grow
and mature, so that it is more responsible and more com-
petent to deal with the manifold demands that impinge
upon it. Here, surely, the work of the minister, the coun-
selor, the teacher, and the parent are all highly pertinent;
and where intensive, specialized psychotherapy becomes
necessary, it is presumably not so much a question of
reversing or undoing the work of others but instead a
matter of trying to carry on where others have left off or
have failed.

On the whole, however, one has the impression that
the development of ego psychology has not as yet pro-
ceeded very far in psychoanalytic quarters. Certainly
Federn's 1952 (posthumous) volume. Ego Psychology
and the Psychoses, cannot be said to have shed any great
new light upon these matters. This book is abstruse and
still so heavily encumbered with classical psychoanalytic
jargon that whatever innovations it contains are very hard
to discover. Far more illuminating and, it would seem,
more promising is the approach suggested by Shoben in
his paper entitled, "Toward a Concept of the Normal
Personality" (1957). Although he does not use the term,
Shoben here is largely concerned with ego psychology. He
says, unequivocally, that the normal, integrated, mature
individual must of necessity be concerned with self-con-
trol, honesty, personal responsibility, and compassion and
affection for others and that how one conceptualizes life
and interpersonal relationships is of the essence. "Ideolo-
gies are at issue here," he frankly says and argues persua-
sively for the importance also of values and value systems.
Here, surely, is an ego psychology — and one with which
the social scientist as well as the theologian can very
largely agree [see also Waelder, I960].

Changing Conceptions of the Unconscious -^

Writing on the Oxford Group movement, in 1950,
Walter H. Clark described the difference between the
aims of psychoanalysis and religion thus: ''Both the psy-
chiatrist and the Group want to reduce the sense of guilt
— the former by reducing the aim, the latter by increas-
ing the accomplishment" (p. 238). While there is no
denying that we sometimes set for ourselves and for
others unrealistic aims, yet it now appears that less harm
is usually done on this score than when an attempt is
made to be dehberately less, morally, than we potentially
are. A scholarly friend tells me that our our word an-
thopoid comes from a Greek word meaning, "with the
head up." And we are apparently in the process of dis-
covering that we cannot solve our problems by looking
"down" without also losing perhaps the most distinctive
aspect of our humanity.

FURTHER IMPLICATIONS

AND CONCLUDING OBSERVATIONS

From the foregoing discussion it would seem that psy-
chology and related disciplines are undergoing a period of
painful reappraisal; and our vision and understanding
are still far from perfect with respect to the end points of
this movement and change. But perhaps the way is suffi-
ciently illuminated for us to see before us a few steps
further.

Jourard says that in assuming that repression can be
directed toward either id or superego, an impasse has
been reached; and we have here tried to cut through that
impasse by exploring the proposition that in psychopa-
thology the trouble arises, not from what is being re-
pressed, but rather from what, in the form of a wrathful
conscience, is being expressed. Past disregard, denial, or
'repression" of conscience may, to be sure, account for
the present outbreak or "attack"; but the very presence of
disturbance means that the repression has broken down.
And the psychotherapeutic task, it would seem, is much
less that of releasing the repressed than of helping the
individual understand what is happening to him and
how he can help make the final outcome constructive
rather than destructive.

However, our hypothesis does not at the same time ex-

^^ ^^ The Crisis in Psychiatry and Religion

elude the possibility of impulse repression, in at least a
limited sense. For some time now I have been interested
in collecting illustrations of seemingly bona fide impulse
repression but which call for an interpretation rather dif-
ferent from the one Freud proposed. From several pos-
sible examples, allow me to select and present the fol-
lowing one, because of its simplicity and brevity. It was
reported to me by a colleague. He said (as I later recon-
structed an informal conversation) :

A week or so ago I had an experience which I think will
interest you, as a psychologist. Some two months ago the
chairman of the program committee of an organization to
which I belong called and asked me to recommend someone
as the speaker at the annual meeting of the organization.
This I did, and I was pleased, when the occasion arrived,
that the person whom I had suggested gave a quite excellent
and well-received talk. Afterward, however, when my wife
and I went home, I found I was vaguely dispirited; and, dur-
ing the period of meditation which I practice before going to
bed each night, I had a very peculiar experience. It was
almost as if there was a "live coal" in a part of my mind, a
sort of localized "anxiety" I suppose you'd call it. Then, all
of a sudden, I realized that I had been jealous of the speaker;
and immediately the "burning" sensation within me dissolved.
I guess I knew I was now in a situation where I couldn't and
wouldn't act upon my jealousy so it was safe for me to have
the feeling. Needless to say, I was ashamed of myself for
having had such a feeling.

Here, apparently, was a situation where conscience, far
from being repressed, had been instead the repressor.
Like a parent who does not entirely "trust" a small child
in some crucial social situation, conscience had held my
friend, so to say, tightly *'in rein" and had released him
only when the chance for misconduct had passed. There
was, presumably, some history of past ungraciousness and
envy in situations such as the one described; and it would
only be with improved self-control and a genuine "change
of heart" on the part of the individual in question that ,
his conscience could "trust" him to handle such a situa-
tion responsibly and well. Here the goal of "therapy"
would not be to release the repressed impulse but rather
to help the individual grow in responsibility and "ego
strength."

The term, ego strength, can of course be easily misun-

Changing Conceptions of the Unconscious B7

derstood. It can be taken to imply independence, self-
sufEciency, and even selfishness and defiance. As we are
presently conceiving of it, the term implies instead
obedience and dedication to broad social objectives and
values. Here the "strong" individual is not an individual
who selfishly demands or refuses but one who instead
serves and is loyal to a set of high social ideals and values.
The point of view here expressed is, of course, mani-
festly similar to that of religion. Our generation is one
which has been said to have lost its "faith in God." Per-
haps this loss of faith is related to a misconception of
God, which the church itself, in recent centuries, has
inadvertently fostered. God, we have been told, is some-
thing out there: and we have forgotten that there is ex-
cellent precedence for thinking of God also as some-
thing in here, a part of our own selves and innermost ex-
perience. For example, consider this passage from I
Kings:

And behold the Lord passed by, and a great and strong
wind rent the mountains, and broke in pieces the rocks be-
fore the Lord, but the Lord was not in the wind; and after
the wind an earthquake, but the Lord was not in the earth-
quake; and after the earthquake a fire, but the Lord was not
in the fire; and after the fire — a still small voice {IS: 11-12).

Can it be that we have lost faith in God because we
have lost faith in conscience? Our widespread use of al-
cohol and other so-called "tranquilizers" is surely, from
one point of view, an expression of distrust of conscience;
and in classical psychoanalysis, with its premise about the
over-severity of the superego, the distrust is even more ex-
plicit. There, as Boisen observes, the therapeutic aim is
likened to that of surgery, with the superego the object of
interest. We are now beginning to suspect that where
psychoanalysis has been successful in its avowed aim, the
result is likely to be, not a normal human being, but a
person with manifest tendencies toward psychopathy and
acting-out; but psychoanalysis is usually not so effective
[cf . Chapter 1 3] . One of the cases cited by Stekel in his
chapter on "diseases of conscience" has to do with a
physician from India who had come to Vienna for treat-
ment — and, also, it seems, because of Vienna's reputa-
tion for liberality in the realm of sex.

38 The Crisis in Psychiatry and Religion

The patient sprang from a pious family [and] I pointed
out that his troubles were due to a disease of conscience, and
told him that the sleeplessness and pruritus would cease to
trouble him if he refrained from the libertinage which was
contrary to the principles in which he had been brought up.
Realizing that I might be right, he broke off all his liaisons
and returned to a fleshless diet. Thereupon the pruritus
ceased, and he slept exceedingly well. . . .

Psychologically interesting is the fact that [the physician
was, however] extremely dissatisfied with the results of the
treatment. He had expected the impossible. I ought to have
freed him from his inward inhibitions, so that he could enjoy
relations with as many women as he pleased (1938, pp. 322-
323).

Conscience would thus seem not readily altered, and
perhaps we would do well to rethink and redirect our
would-be therapeutic strategies. Certainly it is not easy
to be a man as well as an animal, to be dominated by
social as well as biological considerations. But the privilege
of declining to at least make the supreme effort is ap-
parently no longer ours. Man is that remarkable and
paradoxical creature who has, as we may say, domesti-
cated, socialized, and civilized himself, historically speak-
ing; and this same drama, struggle, and high calling is one
which is repeated, in miniature, in each of us. Therefore,
the issues on which our personal success or failure, our
humanity or inhumanity, our sanity or insanity hinges are
as broad as the total human enterprise; and the preven-
tion or correction of our human shortcomings can hardly
be reduced to the level of the services performed by an
automobile mechanic, the pharmacist on the corner, or
even the surgeon — grateful as we are for their expert and
specialized assistance on certain occasions. Surely with
the slogan of the National Association for Mental Health,
we can agree: "Mental health is everybody's business.""
And any attempt, on the part of any professional or spe-
cial-interest group to claim omnipotence and ''full re-
sponsibility" in this field is as presumptuous as it is illogi-
cal.

Is a society "sick" because it has standards, and rules^
and laws and punishes offenders thereof by fines, im-
prisonment, or even death? Who would care to claim
"full responsibility" in this area? The problem is neither
larger nor smaller than our struggle to be fully human.

Changing Conceptions of the Unconscious 39

And is an individual "sick" because he, too, has standards
and punishes himself, sometimes quite severely, for devia-
tion therefrom? A penitentiary is the place we send those
whom society condemns; and a mental hospital is the
abode of the self-condemned — or, as Boisen has called it,
a sort of this-worldly purgatory, from which a person may
return, to a more abundant life, or in which he can also
sink into the hell of a living death [see Chapter 3].

We thought it a great gain when, a century or so ago,
we began to try to perceive the insane as sick rather than
as sinful. But we are now wondering, to put it as a quip,
if sin is not the lesser of two evils [cf . Chapter 4] . Citing
the supporting views of Marzolf and Riese, Shoben says :

Recently, there has been a considerable dissatisfaction with
the whole notion of interpreting psychological states in
terms of disease analogies. Maladjustive behavior patterns, the
neuroses, and — perhaps to a lesser extent — the psychoses
may possibly be better understood as disordered, ineffective,
and defensive styles of life than as forms of sickness (1957,
p. 184).

One of the features of the Protestant Reformation that
gave it such dynamic power and wide appeal was the doc-
trine of "the priesthood of all believers" and belief in
"the sanctity of the common life." Nothing, it would
seem, short of a similarly broad and universal invitation
and challenge, to each and every member of contem-
porary society, can represent a fully rational and poten-
tially more effective attack upon contemporary man's
faltering faith and tottering reason.

Some Constructive Features
of the Concept of Sin*

As long as one adheres to the theory that psychoneuro- j
sis implies no moral responsibility y no error, no misdeed j
on the part of the afflicted person, ones vocabulary can, ■
of course, remain beautifully objective and '' scientific ^ \
But as soon as there is so much as a hint of personal ac- \
countability in the situation, such language is, at the i
very least, wide of the mark and, conceivably, quite mis- ]
leading. Therefore, if ''moral judgment'' does enter the \
picture, one might as well beard the lion and use the \
strongest term of all, sin. This is the strategy involved in •
the present and following chapter. 1

But there is also a deeper objective here. ''Sickness/* as \
we shall see increasingly in later chapters, is a concept ]
which generates pervasive pessimism and confusion in
the domain of psychopathology; whereas sin, for all its
harshness, carries an implication of promise and hope, a
vision of new potentialities. Just so long as we deny the
reality of sin, we cut ourselves off, it seems, from the
possibility of radical redemption {"recovery*').

In some ways it is perhaps not surprising that we are ■
assembled here today to explore the question of whether ^
real guilt, or sin, is relevant to the problem of psychopa-
thology and psychotherapy. For half a century now we I
psychologists, as a profession, have very largely followed ^
the Freudian doctrine that human beings become emo- J
tionally disturbed, not because of their having done any- 1

* One of four papers comprising a symposium on "The Role |
of the Concept of Sin in Psychotherapy" held at the 1959 |
meeting of the American Psychological Association, in Cin- i
cinnati, Ohio {American Psychologist, 1959, 14, 356) and later |
published in the Journal of Counseling Psychology, 1960, 7,
185-1 8 8. This paper has also appeared, without authorization, in
Catholic Mind, 1960, S8, 151-155.)

40

Constructive Features of Concept of Sin 41

thing palpably wrong, but because they instead lack in-
sight. Therefore, as would-be therapists we have set out
to oppose the forces of repression and to work for under-
standing. And what is this understanding, or insight,
which we so highly prize? It is the discovery that the
patient or client has been, in effect, too good; that he
has within him impulses, especially those of lust and
hostility, which he has been quite unnecessarily inhibit-
ing. And health, we tell him, lies in the direction of
recognizing and expressing these impulses.

But there are now widespread and, indeed, ominous
signs that this logic and the practical strategies it seems
to demand are ill-founded. The situation is, in fact, so
grave that, as our presence here today suggests, we are
even willing to consider the possibility that misconduct
may, after all, have something to do with the matter and
that the doctrine of repression and insight are more mis-
leading than helpful.

However, as soon as we psychologists get into a dis-
cussion of this problem, we find that our confusion is
even more fundamental than might at first appear. We
find that not only have we disavowed the connection
between manifest misconduct and psychopathology; we
have, also, very largely abandoned belief in right and
wrong, virtue and sin, in general.

On other occasions when I have seen this issue under
debate and anyone has proposed that social deviousness
is causal in psychopathology, there is always a chorus of
voices who clamor that sin cannot be defined, that it is
culturally relative, that it is an unscientific concept, that
it is a superstition — and therefore not to be taken se-
riously, either in psychopathology or in ordinary, every-
day experience. And whenever an attempt is made to
answer these objections, there are always further objec-
tions — often in the form of reductions to absurdity —
which involve naivity or sophistry that would ill-become
a schoolboy. Historically, in both literate and non-literate
societies, human beings are supposed to have reached the
age of discretion by early adolescence; yet here we have
the spectacle of grown men and women soberly insisting
that, in effect, they cannot tell right from wrong — and
that no one else can.

Now I realize how futile it is to try to deal with this

42 The Crisis in Psychiatry and Religion

kind of attitude in a purely rational or logical way. The
subversive doctrine that we can have the benefits of
orderly social life without paying for it, through certain
restraints and sacrifices, is too alluring to be counteracted
by mere reason. The real answer, I believe, lies along
different lines. The unassailable, brute fact is that per-
sonality disorder is the most pervasive and baffling prob-
lem of our time; and if it should turn out that persons
so afflicted regularly display (or rather hide) a life of
too little, rather than too much, moral restraint and self-
discipline, the problem would take on an empirical
urgency that would require no fine-spun argument.

Sin used to be — and, in some quarters, still is — defined
as whatever one does that puts him in danger of going to
Hell. Here was an assumed cause-and-effect relationship
that was completely metaphysical and empirically un-
verifiable; and it is small wonder that it has fallen into
disrepute as the scientific outlook and method have
steadily gained in acceptance and manifest power. But
there is a very tangible and very present Hell-on-this-earth
which science has not yet helped us understand very
well; and so I invite your attention to the neglected but
very real possibility that it is this Hell — the Hell of
neurosis and psychosis — to which sin and unexpiated
guilt lead us and that it is this Hell that gives us one of
the most, perhaps the most realistic and basic criteria for
defining sin and guilt. If it proves empirically true that
certain forms of conduct characteristically lead human
beings into emotional instability, what better or firmer
basis would one wish for labeling such conduct as destruc-
tive, self-defeating, evil, sinful? ^

If the Freudian theory of personality disorder were
valid, one would expect neurotic and psychotic individuals
to have lead exemplary, yea saintly lives — to have been

^ There is, admittedly, an element of circularity in the above
argument. If it is maintained that mental illness is caused by
unacknowledged and unexpiated sin, or real guilt, then it adds
nothing to our knowledge to define sin as that which causes
mental illness. In fact, there is a sense in which such a defini-
tion is not only circular but misleading (see Chapter 13). Ob-
viously, what is needed is an independent criterion for identify-
ing sin or guilt — cf. Chapters 10-11 and Mowrer, 1961.

Constructive Features of Concept of Sin 45

just too good for this world. The fact is, of course, that
such individuals typically exhibit lives that have been dis-
orderly and dishonest in extreme degree. In fact, this is
so regularly the case [see Chapters 8 and 13] that one
cannot but wonder how so contrary a doctrine as that of
Freud ever gained credence. Freud spurned The Wish
and exalted Reality. What he regarded as Reality may
yet prove to have been the biggest piece of wishfulness of
all.

Or, it may be asked, how is it if sin and psychic suffer-
ing are correlated that not all who sin fall into neurosis
or psychosis? Here the findings of the Kinsey studies are
likely to be cited, showing that, for example, many per-
sons have a history of sexual perversity who are later quite
normal. In other words, the argument is that since sin
and persistent suffering do not always go hand-in-hand,
there is perhaps no relationship at all. The answer to
this question is surely obvious. Some individuals, alas^
simply do not have enough character, or conscience, to
be bothered by their sins. These are, of course, the
world's psychopaths. Or an individual may have been
caught in his sin and punished for it. Or it may have
weighed so heavily on his conscience that he himself
has confessed it and made appropriate expiation. Or^
quite conceivably, in some instances the individual, with-
out either detection or confession, may have set upon a
program of service and good works which has also brought
him peace and redemption. In other words, there is,
surely, no disposition on the part of anyone to hold that
sin, as such, necessarily dooms a person to interminable
suffering in the form of neurosis or psychosis. The pre-
sumption is rather that sin has this effect only where it
is acutely felt but not acknowledged and corrected.

Also, it is sometimes contended that individuals who
eventually come to the attention of psychotherapists have,
to be sure, been guilty of major errors of conduct; but,
it is held, the illness was present first and the misconduct
|was really just an expression or symptom thereof. If this
were true, where then would we draw the line? Is there
no such thing as moral responsibility and social ac-
countability at all? Is every mean or vicious thing that
you or I, as ordinary individuals, do not sin but rather an

44 The Crisis in Psychiatry and Religion

expression of "illness"? Who would seriously hold that a
society could long endure which consistently subscribed
to this flaccid doctrine?

Then there is, of course, the view that, in the final
analysis, all psychopathology — or at least its profounder
forms — have a constitutional or metabolic basis. One
must, I believe, remain open-minded with respect to this
possibility — indeed, perhaps even somewhat hopeful with
respect to it; for how marvelous it would be if all the
world's madness, stupidity, and meanness could be elimi-
nated through biochemistry. But over the years we have
seen one approach after another of this kind come into
prominence, with much heralding as the long-awaited
break-through on the problem of mental disease, only to
fade out as manifestly not quite the panacea we had
imagined it to be. Some of us may, at this point, even
suspect that today the main incentive for keeping the
biochemical hypothesis alive is not so much the support-
ing empirical evidence, which is meager enough, but in-
stead the fact that it at least obliquely justifies the
premise that the whole field of mental disorder is the
proper and exclusive domain of medicine. Also, and
again somewhat obliquely, it excuses the clergy from
facing squarely the responsibilities that would devolve
among them if neurosis and psychosis should indeed
turn out to be essentially moral disorders.

The conception of personality disturbance which at-
taches major etiological significance to moral and inter-
personal considerations thus faces formidable resistance,
from many sources; but programs of treatment and pre-
vention which have been predicated on these other views
have gotten us nowhere, and there is no clear reason to
think they ever will. Therefore, in light of the total situa-
tion, I see no alternative but to turn again to the old,
painful, but also promising possibility that man is pre-
eminently a social creature and that he lives or dies,
psychologically and personally, as a function of the open-
ness, community, relatedness, and integrity which by
good action he attains and by evil action destroys.

As long as we could believe that the psychoneurotic's
basic problem was not evil but a kind of ignorance, it
did not seem too formidable a task to give him the^
requisite enlightenment or insight. But mental hospital^

Constructive Features of Concept of Sin 45

are now full of people who have had this kind of therapy,
in one guise or another, and found it wanting; and if we
are thus forced to reconsider the other alternative, the
therapeutic or redemptive enterprise, however clear it
may be in principle, is by no means simple in practice. If
the problem is genuinely one of morality, rather than
pseudo-morality, most of us in the secular healing profes-
sions, of psychology, psychiatry, or social work, find our-
selves reduced to the status of laymen, with no special
itraining or competence for dealing with or even approach-
ing the problem in these terms. We know something, of
course, about procedures for getting disturbed persons to
talk about themselves, free-associate, "confess"; but the
Iwhole aim of this strategy has been insight, not redemp-
tion and personal reformation. And clergymen themselves
Eave so often been told, both by their own leaders and
y members of the secular healing professions, that they
must recognize their own "limitations" and know when
to "refer" that they, too, lack the necessary confidence
and resources for dealing with these problems ade-
quately [cf. Chapters 11, 12].

Many present-day psychoanalysts will offer no serious
objection to the way in which classical Freudian theory
and practice have been evaluated in this paper; but they
will insist that many "advances" have been made since
Freud's time and that these put the whole problem in a
very different light. If we ask, "Precisely what are these
advances?" we are told that they have to do with the
pew emphasis upon "ego psychology" rather than upon
I'the unconscious." But what did Emalian Gutheil
(1958) tell us at our convention last year in Washington
ibout ego psychology? He said that although analysts
low recognize the ego as much more important than
"ormerly, they know next to nothing about the conditions
"or modifying or strengthening it; and the same position
las been voiced earlier by Lawrence Kubie (1956) and
in one of his very last papers (1937) even by Freud him-
jelf [see also Chapter 13].

' Therefore, I do not see how we can avoid the conclu-
sion that at this juncture we are in a real crisis with
respect to the whole psychotherapeutic enterprise. But I
do not think we are going to remain in this crisis, con-
"used and impotent, indefinitely. There is, I believe, grow-

46 The Crisis in Psychiatry and Religion

ing realism with regard to the situation on the part of
both psychologists and psychiatrists, on the one hand,
and ministers, rabbis, and priests, on the other; and I am
hopeful and even confident that new and better ways of
dealing with the situation are in the making.

What, precisely, these ways will be I do not know; but :
I venture the impression that Alcoholics Anonymous;
provides our best present intimation of things to come:
and that the therapeutic programs of the future, whethen
under religious or secular auspices, will, like AA, take:
guilt, confession, and expiation seriously and will involve:
programs of action rather than mere groping for "in-
sight" [cf. Chapters 8 and 12].

4

*'Sin," the Lesser of Two Evils*

When the paper which constitutes the preceding chap-
ter was delivered at the symposium for which it was pre-
pared, it created something of a ''sensation^ There was
considerable stir over it at the convention itself; and
stories appeared widely in newspapers and national maga-
zines, including Time [Sept. 14, 1959 — *'The idea of sin,
at least for use in treating the sick psyche, is making a
comeback/' p. 69), Newsweek {Sept. 14, 1959, p. 108),
and America {Sept. 12, 1960, pp. 686-687).

Because the symposium paper was, of necessity, brief
and left many facets of a complex problem unexplored,
it seemed desirable to write a supplementary paper,
which is reproduced herewith. In it a number of con-
siderations are touched upon which open the way for
more systematic discussion in subsequent chapters.

Following the presentation of a paper on ''Construc-
tive Aspects of the Concept of Sin in Psychotherapy" at
the 1959 APA convention in Cincinnati, I have re-
peatedly been asked by psychologists and psychiatrists :
"But why must you use that awful word 'sin,' instead of
some more neutral term such as 'wrongdoing,' 'irre-
sponsibility,' or 'immorality'?" And even a religious lay-
man has reproached me on the grounds that "Sin is such
a strong word." Its strength, surely, is an asset, not a
Hability; for in the face of failure which has resulted from
our erstwhile use of feebler concepts, we have very heavy
work for it to do. Besides, sin (in contrast to its more
neutral equivalents) is such a handy little word that it
would be a pity to let it entirely disappear from usage.
With Humpty-Dumpty, we ought to expect words to be
"well-behaved" and to mean what we want them to!

* Read at a luncheon meeting of The University Religious
Council, Ohio State University, Columbus, March 11, 1959,
and published in The American Psychologist, 1960, 15, 301-
'304.

i 47

48 The Crisis in Psychiatry and Religioi

A few years ago I was invited to teach in the summ(
session at one of our great Pacific Coast universities; anc
toward the end of the term, a student in my class on
Personahty Theory said to me one day: ''Did you know
that near the beginning of this course you created a kind
of scandal on this campus?" Then he explained that I
had once used the word "sin" without saying "so-called"
or making a joke about it. This, the student said, was
virtually unheard-of in a psychology professor and had
occasioned considerable dismay and perplexity. I did not
even recall the incident; but the more I have thought
about the reaction it produced, the more frequently I
have found myself using the term — with, I hope, some-
thing more than mere perversity.

Traditionally, sin has been thought of as whatever
causes one to go to Hell; and since Hell, as a place of
otherworldly retribution and torment, has conveniently
dropped out of most religious as well as secular thought,
the concept of sin might indeed seem antiquated and
absurd. But, as I observed in the Cincinnati paper. Hell
is still very much with us in those states of mind and
being which we call neurosis and psychosis; and I have
come increasingly, at least in my own mind, to identify
anything that carries us toward these forms of perdition
as sin. Irresponsibility, wrongdoing, immorality, sin:^
what do the terms matter if we can thus understand
more accurately the nature of psychopathology and gain
greater practical control over its ramified forms and
manifestations?

But now the fat is in the fire! Have we not been
taught on high authority that personality disorder is not
one's own "fault," that the neurotic is not "responsible"
for his suffering, that he has done nothing wrong, com-
mitted no "sin"? "Mental illness," according to a poster
which was widely circulated a few years ago, "is no dis-
grace. It might happen to anyone." And behind all this,
of course, was the Freudian hypothesis that neurosis stems
from a "too severe superego," which is the product of a
too strenuous socialization of the individual at the hands
of harsh, unloving parents and an irrational society. The^
trouble lay, supposedly, not in anything wrong or "sinful"
which the individual has himself done, but in things he
merely wants to do but cannot, because of repression.

"Sin," the Lesser of Two Evils 49

The neurotic was thus not sinful but sick, the helpless,
innocent victim of "the sins of the fathers," and could
be rescued only by a specialized, esoteric form of treat-
ment. Anna Russell catches the spirit of this doctrine well
when she sings, in 'Tsychiatric Folksong,"

At three I had a feeling of

Ambivalence toward my brothers,
And so it follows naturally

I poisoned all my lovers.
But now I'm happy; I have learned

The lesson this has taught;
That everything I do that's wrong

Is someone else's fault.

Freud saw all this not only as a great scientific dis-
covery but also as a strategic gain for the profession
which had thus far treated him so indifferently. It was
one may conjecture, a sort of gift, an offering or service
which would place medicine in^^ueh debt to him that
it could no longer ignore or reject him. In his Auto-
TwgraphyTimd { 193 5 ) puts it thus:

My medical conscience felt pleased at my having arrived
at this conclusion [that neurosis has a sexual basis]. I hoped
that I had filled up a gap in medical science, which, in deal-
ing with a function of such great biological importance, had
failed to take into account any injuries beyond those caused
by infection or by gross anatomical lesions. The medical
aspect of the matter was, moreover, supported by the fact that
sexuality was not something purely mental. It had a somatic
side as well . . . (p. 45).

In his book on The Problem of Lay Analysis^ Freud
(1927) later took a somewhat different position (see also
Chapter 9 of the third volume of Jones' biography of
Freud, 1957); but by this time his Big Idea had been let
loose in the world and was no longer entirely under his
control.

Psychologists were, as we know, among the first of
the outlying professional groups to "take up" psycho-
analysis. By being analyzed, we not only learned — in an
intimate, personal way — about this new and revolutionary
science; we also (or so we imagined) were qualifying
ourselves for the practice of analysis as a form of therapy.

50 The Crisis in Psychiatry and Religion

Now we are beginning to see how illusory this all was.
We accepted psychoanalytic theory long before it had
been adequately tested and thus embraced as ''science"
a set of presuppositions which we are now painfully hav-
ing to repudiate. But, more than this, in accepting the
premise that the neurotically disturbed person is basically
sick, we surrendered our professional independence and
authenticity. Now, to the extent that we have subscribed
to the doctrine of mental illness (and tried to take part
in its "treatment"), we have laid ourselves open to some
really very embarrassing charges from our friends in psy-
chiatry.

In 1954 the American Psychiatric Association, with
the approval of the American Medical Association and
the American Psychoanalytic Association, published a
resolution on "relations between medicine and psy-
chology," which it re-issued (during the supposed "mor-
atorium") in 1957. This document needs no exten-
sive review in these pages; but a few sentences may be
quoted to indicate what a powerful fulcrum the sickness
conception of neurosis provides for the aggrandizement
of medicine.

For centuries the Western world has placed on the medi-
cal profession responsibility for the diagnosis and treatment
of illness. Medical practice acts have been designed to protect
the public from unqualified practitioners and to define the
special responsibilities assumed by those who practice the
healing art. . . . Psychiatry is the medical speciality con-
cerned with illness that has chiefly mental symptoms. . . .
Psychotherapy is a form of medical treatment and does not
form the basis for a separate profession. . . . When mem-
bers of these [other] professions contribute to the diagnosis
and treatment of illness, their professional contributions must
be coordinated under medical responsibility (pp. 1-2).

So long as we subscribe to the view that neurosis is a i
bona fide "illness," without moral implications or dimen-
sions, our position will, of necessity, continue to be an
awkward one. And it is here I suggest that, as between
the concept of sin (however unsatisfactory it may in
some ways be) and that of sickness, sin is indeed the
lesser of two evils. We have tried the sickness horn of
this dilemma and impaled ourselves upon it. Perhaps,

"Sin," the Lesser of Two Evils 51

despite our erstwhile protestations, we shall yet find sin
more congenial.

We psychologists do not, I believe, object in principle
to the type of authority which psychiatrists wish to exer-
cise, or to our being subject to other medical controls,
if they were truly functional. But authority and power
ought to go with demonstrated competence, which medi-
cine clearly has in the physical realm but, equally clearly,
jdoes not have in "'psychiatry." Despite some pretentious
affirmations to the contrary, the fact is that psycho-
;analysis, on which modern "dynamic" psychiatry is largely
ibased, is in a state of virtual collapse and imminent
idemise. And the tranquilizers and other forms of so-
called chemotherapy are admittedly only ameliorative,
not basically curative. So now, to the extent that we
have accepted the "illness" postulate and thus been
lured under the penumbra of medicine, we are in the
ungraceful maneuver of "getting out." ^

But the question remains: Where do we go, what do
we do, now? Some believe that our best policy is to
become frankly agnostic for the time being, to admit
that we know next to nothing about either the cause or
correction of psychopathology and therefore ought to
concentrate on research. This is certainly a safe policy,
and it may also be the wisest one. But since this matter
of man's total adjustment and psychosocial survival does
not quickly yield up its innermost secrets to conventional
types of scientific inquiry, I believe it will do no harm
for us at the same time to be thinking about some
frankly ideological matters.

^Thoughtful psychiatrists are also beginning to question the
legitimacy of the disease concept in this area. In an article en-
titled 'The Myth of Mental Illness" which appeared after this
paper went to press, Thomas S. Szasz (1960) is particularly
outspoken on this score. He says: ". . . the notion of mental
illness has outlived whatever usefulness it might have had and
. . . now functions merely as a convenient myth. . . . mental
illness is a myth, whose function it is to disguise and thus
render more palatable the bitter pill of moral conflicts in hu-
man relations" (p. 118). Szasz entire article deserves careful
attention.

52 The Crisis in Psychiatry and Religion

For several decades we psychologists looked upon the
whole matter of sin and moral accountability as a great
incubus and acclaimed our liberation from it as epoch-
making. But at length we have discovered that to be
"free" in this sense, i.e., to have the excuse of being
"sick" rather than sinful, is to court the danger of also
becoming lost. This danger is, I believe, betokened by
the widespread interest in Existentialism which we are
presently witnessing. In becoming amoral, ethically neu-
tral, and "free," we have cut the very roots of our being;
lost our deepest sense of self-hood and identity; and,
with neurotics themselves, find ourselves asking: Who
am I? What is my destiny? What does living (existence)
mean?

In reaction to the state of near-limbo into which we
have drifted, we have become suddenly aware, once
again, of the problem of values and of their centrality
in the human enterprise. This trend is clearly apparent
in the programs at our recent professional meetings, in
journal articles, and, to some extent already, in our
elementary textbooks. Something very basic is obviously
happening to psychologists and their "self-image."

In this process of moving away from our erstwhile
medical "entanglements," it would be a very natural
thing for us to form a closer and friendlier relationship
than we have previously had with religion and theology.
And something of this sort is unquestionably occurring.
At the APA Annual Convention in 1956 there was, for
the first time in our history I believe, a symposium on
religion and mental health; and each ensuing year has;
seen other clear indications of a developing rapproche-;
ment. |

However, here too there is a difficulty — of a most
surprising kind. At the very time that psychologists are
becoming distrustful of the sickness approach to person-
ality disturbance and are beginning to look with more
benign interest and respect toward certain moral and
religious precepts, religionists themselves are being caught
up in and bedazzled by the same preposterous system of
thought as that from which we psychologists are just
recovering. It would be possible to document this develop-
ment at length; but reference to such recent "theological"
works as Richard V. McCann's Delinquency — Sicknesi

'Sin," the Lesser of Two Evils 53

or Sin? (1957) and Carl Michalson's Faith for Personal
Crises (1959, see especially Chapter 3) will suffice.

We have alluded to Anna Russell's ''Psychiatric Folk-
song" and, in addition, should call attention to Katie
Lee's 12-inch LP recording "Songs of Couch and Con-
sultation." That entertainment and literary people are
broadly rejecting psychoanalytic froth for the more solid
substance of moral accountability is indicated by many
current novels and plays. It is not without significance
that Arthur Miller's Death of a Salesman, written in the
philosophical vein of Hawthorne's great novel The
pcarlet Letter, has, for example, been received so well.

How very strange and inverted our present situation
therefore is! Traditionally clergymen have worried about
the world's entertainments and entertainers and, for a
time at least, about psychology and psychologists. Now,
ironically, the entertainers and psychologists are worrying
about the clergymen. Eventually, of course, clergymen
will return to a sounder, less fantastic position; but in
the nieantime, we psychologists can perhaps play a socially
useful and, also, scientifically productive role if we pursue,
ivith all seriousness and candor, our discovery of the
essentially moral nature of human existence and of that
'living death" which we call psychopathology. This, of
course, is not the place to go deeply into the substantive
aspects of the problem; but one illustration of the fruit-
ulness of such exploration may be cited.

In reconsidering the possibility that sin must, after
ill, be taken seriously, many psychologists seem per-
plexed as to what attitude one should take toward the
nnner. "Nonjudgmental," "nonpunitive," "nondirective,"
warm," "accepting," "ethically neutral": these words
liave been so very generally used to form the supposedly
Droper therapeutic imago that reintroduction of the
oncept of sin throws us badly off balance. Our attitudes,
is would-be therapists or helping persons, toward the
aeurotic (sinner) are apparently less important than his
ittitude toward himself; and, as we know, it is usually —
in the most general sense — a rejecting one. Therefore,
we have reasoned, the way to get the neurotic to accept
md love himself is for us to love and accept him, an
nference which flows equally from the Freudian assump-

54 The Crisis in Psychiatry and Religion

tion that the patient is not really guilty or sinful but
only fancies himself so and from the view of Rogers
that we are all inherently good and are corrupted by our
experiences with the external, everyday world.

But what is here generally overlooked, it seems, is
that recovery (constructive change, redemption) is most
assuredly attained, not by helping a person reject and
rise above his sins, but by helping him accept them.
This is the paradox which we have not at all understood
and which is the very crux of the problem. Just so long
as a person lives under the shadow of real, unacknowl-
edged, and unexpiated guilt, he cannot (if he has any
character at all) ''accept himself"; and all our efforts to
reassure and accept him will avail nothing. He willi
continue to hate himself and to suffer the inevitable
consequences of self-hatred. But the moment he (with
or without "assistance") begins to accept his guilt and!
his sinfulness, the possibility of radical reformation opens
up; and with this, the individual may legitimately, though
not without pain and effort, pass from deep, pervasive
self-rejection and self-torture to a new freedom, of self-
respect and peace.

Thus we arrive, not only at a new (really very old) |
conception of the nature of ''neurosis" which may change j
our entire approach to this problem, but also at an
understanding of one of the most fundamental fallacies
of Freudian psychoanalysis and many kindred efforts at.
psychotherapy. Freud observed, quite accurately, that the
neurotic tortures himself; and he conjectured that this
type of suffering arose from the irrationality and over-
severity of the superego. But at once there was an em-
pirical as well as logical difficulty which Freud (unlike
some of his followers) faithfully acknowledged. In the
New Introductory Lectures on Psychoanalysis (1933),
he said:

The supergo [paradoxically] seems to have made a one-
sided selection [as between the loving and the punitive atti-
tudes of the parents], and to have chosen only the harshness,
and severity of the parents, their preventive and punitive
functions, while their loving care is not taken up and con-
tinued by it. If the parents have really ruled with a rod of
iron, we easily understand the child developing a severe su-
perego, but, contrary to our expectations, experience shows

Sin," the Lesser of Two Evils 55

that the supergo may reflect the same relentless harshness
even when the up-bringing has been gentle and kind (p. 90).

And then Freud adds, candidly: *'We ourselves do not

feel that we have fully understood it." In this we can

illy agree. For the only way to resolve the paradox of

If-hatred and self-punishment is to assume, not that

represents merely an "introjection" of the attitudes of

thers, but that the self-hatred is realistically justified and

ill persist until the individual, by radically altered atti-

de and action^ honestly and realistically comes to feel

at he now deserves something better. As long as one

mains, in old-fashioned religious phraseology, hard-of-

eart and unrepentant, just so long will one's conscience

old him in the vise-like grip of "neurotic" rigidity and

offering. But if, at length, an individual confesses his

ast stupidities and errors and makes what poor attempts

le can at restitution, then the superego (like the parents

an earlier day — and society in general) forgives and
laxes its stern hold; and the individual once again is
ee, "well" [cf. Chapter 2].

But here we too, like Freud, encounter a difficulty,
here is some evidence that human beings do not change
idically unless they first acknowledge their sins; but we
so know how hard it is for one to make such an
knowledgment unless he has already changed. In other
ords, the full realization of deep worthlessness is a
vere ego "insult"; and one must have some new source

strength, it seems, to endure it. This is a mystery (or

it only a mistaken observation?) which traditional
leology has tried to resolve in various ways — v/ithout
)mplete success. Can we psychologists do better?

\

Judgment and Suflfering:
Contrasting Views*

It has been argued that if real rather than false (Freud-
ian) guilt is at the root of neurosis and functional
psychosis, then therapy should, logically, take the form
of ''punishment'' rather than ''treatment^ Yet the elim-
ination of punishment ["mistreatment'') of the insane
has been regarded as a great cultural and humane achieve-
ment of the last century or two. Here, obviously, is c
complicated issue, which has already been alluded to neat
the end of the preceding chapter. While it is not certair,
j that punishment from without {e.g., the use of electro-
j convulsive shock) has no legitimate place in a restorative
\ program, the fact is that the distinguishing feature O]
most forms of psychopathology is that the individua
is punishing himself — or at least trying to. The questior
is. How should we interpret this tendency, as "crazy']
or potentially curative? Other aspects of this intricaU
but important problem will be considered, from timi
to time, in later chapters.

In May, 1959, it was my good fortune to participate
in a week-long institute held at the University of Sas
katchewan under the auspices of the Provincial Govern
ment, primarily for psychologists; but there were alsc
three psychiatrists and a clergyman in the group, so tha
our discussions had a distinctly interdisciplinary flavor
And from these discussions emerged what was for me 5
new insight concerning contemporary attitudes towarc
suffering which I believe deserves wider consideration

During the course of the lectures which it was m;
privilege to give, I reiterated a point of view concerninj
the origin and meaning of psychopathology which ha
been taking shape in my mind over the course of th<
past 12 or 15 years. Guilt, I argued, is the central prob
lem — not just guilt feelings, as Freud so beguilingl;

* Initially published in Faculty Forum, October, 1959, pp
1-2.

56

JDGMENT AND SUFFERING 57

iggested, but real, palpable, indisputable guilt; and
ere I was at pains to review clinical evidence that dis-
irbed persons are not ^'disturbed" for nothing. Where
eurosis or psychosis is purely functional (as it usually
) , the individual, I believe, always has a hidden history
E serious misconduct which has not been adequately
Dmpensated and ''redeemed." And if this be so, then
Dnfession, expiation, and ''a new life in Christ" (or
)me equivalent type of conversion) have a practical
ertinence which far exceeds the boundaries behind
hich some theologians have attempted to hold them.
There was, I may say, an immediately positive response
) this point of view on the part of many members of
le group, including one of the psychiatrists and several
f the psychologists. But there was also manifest reserva-
on and resistance on the part of others; so we took
)me time to hear these persons out and try to under-
:and their misgivings.

; Presently it emerged that several of the members of

[ir group felt that this point of view was ''punitive"

jid "rejecting" and "countertherapeutic"; for how could

ae accept it, they asked, without blaming the patient

id being disposed to punish him? These avowals brought

;veral important issues out into the open. First of all,

ley permitted other members of the group to point out

lat no one else needs to blame or punish the mental

ifferer: he is blaming and punishing himself (or at least

ying to) — this is the very essence of his condition.

herefore, we can and should show him all the love and

larity within our souls, and do not need in the least to

ay a punitive role. But this is very different from saying

lat we should dispute or brush aside his assertions of

lilt or minimize the reality of his need for deliverance.

veral members of the group expressed the conviction

at much of our present would-be therapeutic effort

useless and even harmful because we so actively oppose

e patient's own most substantial psychological realities

d his brightest prospects for change and recovery, i.e.,

5 conviction of guilt and sense of sin. Perhaps the

tient is not so wrong, not so "crazy" as some of our

m theories have been!

Then our discussion took a historical turn, and we
:gan to see how widespread and pervasive has been, in

58 The Crisis in Psychiatry and Religio

recent times, the belief that suffering is never "de-
served/' never creative and reconstructive. It can hardl)
be doubted that in many primitive societies the notion
of accountabihty is overworked; and one can point tc
clear examples of the same sort of thing in the history
of Western civilization. For example, not so long ago we
held that physical illness and accidents were **God's
judgment" rather than the wholly impersonal conse-
quences of germs or other circumstances beyond the
individual's control; and we also were inclined, until
fairly recently, to suppose that all poverty must reflect
sloth or other sins, rather than recognize social injustice
and economic exploitation.

But now, in our reaction against this patent overexten-
sion of ''moral" principle, have we not gone too far iii
the other direction? There is, as we know, a widespreac
tendency — sometimes called "scientism" — to assume thai
human beings cannot be ''responsible" for anything, thai
we are all just cogs in a vast cause-and-effect comple?
and are in no way accountable for anything we do oi
anything that happens to us. Such a doctrine, aside fron
its lack of genuine scientific justification, is devastating
no society could long endure which thoroughly acceptec
it — and neither can an individual human being [cf
Mowrer, 1961].

As we look around us, at mid-twentieth century, tw(
of the most distressing "symptoms" of our times are (a)
confusion and apathy in the matter of moral value
(witness the "beatnik" movement) and (b) an apparen
paralysis with respect to the spectre of mental illness
Can it be that the two conditions are related and tha
they exist in such acute form precisely because we havt
insisted upon separating them? Perhaps mental dis-easi
has a meaning and a potential which we fail to recognize

The whole thrust of medicine is, of course, in th(
direction of the "alleviation of suffering"; and we an
deeply grateful for most medical efforts and accomplish
ments. But when medicine extends this principle ove
into the moral realm, as it ostensibly does in its attemp
to treat personality disorders, the results are far fron
reassuring. Psychoanalysis promised to deliver us frori
neurotic suffering by the bold expedient of reducing th
"severity" of our consciences. Unable to make good thi

UDGMENT AND SUFFERING 59

iromise, analysis is on the wane; and psychiatry is now

aptivated by the chemical "tranquilizers." Pick up an

5sue of the American Journal of Psychiatry (as I recently

lid) and what do you find? Nine of the ten full-page

T two-page advertisements in the front of the journal

sading as follows: "control of emotional turbulence

-luminal/' "peace of mind — atarax," "calmness, co-

perativeness — serpasil," "relief of anxiety — compazine,"

valuable in all degrees of psychic disorder — trilafon,"

intravenous anesthetic — pentothal," "relieves tension —

quanil," "normalizes thinking — pacatal," "produces re-

ixation — sandril." The other ad was for a portable tape

ecorder! Combine with this the fact that such a large

ercentage of other forms of advertising are for those

e-old "tranquilizers," alcohol and tobacco, and one

es that the diagnosis of our time as the "Aspirin Age"

a magnificent understatement. What would happen

modern man were forced to confront his guilt and

security for just one week without these masks and

dutches? Would it destroy us completely or perhaps

pint the way to a saner and better life?

Historically, the church has been dedicated not to

mfort but to change, redemption, rebirth. Ultimately

s objective, no less than that of medicine, was to relieve

ffering — ^yea, more, to bring salvation and joy. But it

d not flinch from holding that sometimes suffering is

e absolute and inescapable precondition for our trans-

)rmation and redemption. What of the modern church?

s child-rearing became permissive, religion also became

ion judgmental" and obligingly eliminated Hell. God

now love and love alone, and judgment is old-fash-

med. This past week a student put into my hands a

eekly bulletin from one of our local Protestant churches

hich proclaims that God is "a generous, loving Father"

pose "favor toward man is freely given" and takes the

Oman Catholics to task for "emphasizing that God is

pod of justice"!

Old Testament writers knew that God and parents
id conscience can be justifiably angry and that we
nore them at our peril. In denying the moral implica-
Dns of suffering and seeking to cushion ourselves against
do we not misperceive and mismanage it in wa.yr
hich, in the long run, can only spell disaster?

The New Challenge to our Qiurches
and Seminaries:

I. A Question of Theory* j

In the preceding chapters, attention has been mainlj
directed to the "crisis'* in psychiatry and clinical psy
chology which has been occasioned by the pervasiv^
acceptance of Freudian psychoanalysis, with its basically
biological orientation and emphasis. In this chapter am
the immediately succeeding ones, we now look, mon
explicitly, at the predicament of the churches and semi
naries. At prst slow to accept Freudianism, they are todo)
displaying an astonishing reluctance to let go of it. Tni
chapter gives some little-known facts about the histor}
of the pastoral counseling movement and shows how
after a promising start in the right direction, it was de
fleeted and distorted by psychoanalytic theory and non
directive counseling techniques.

Initially written, by invitation, for a well known re
ligious periodical, this paper {and its sequel, see Chaptei
7) was formally accepted and then mysteriously rejected
Did the latter action reflect defensiveness and reluctanci
to face up to some unpleasant facts? Or is there some
thing basically inaccurate or perhaps unfair in the presem
analysis? |

Has evangelical religion sold its birthright for a mes!
of psychological pottage? In attempting to rectify theii
disastrous early neglect of psychopathology, have th<
churches and seminaries assimilated a viewpoint anc
value system more destructive and deadly than the evi
they were attempting to eliminate? As a psychologist
and churchman, I believe the answer to these question;
is in the afErmative. If so, the time is upon us for i
searching reappraisal and a new plan of action.

But first let me correct a possible misapprehension

* Published in Foundations: A Baptist Journal of Histor)
and Theology, October, 1960, 3, 335-347.

60

lALLENGE TO OuR ChURCHES: I. ThEORY 61

lere are, I know, some ministers and seminary profes-
:s who would be only too happy to have done with
s whole "clinical movement." I mean to give them no
mfort; for I agree completely with Harry Emerson
isdick when he says (in a recent article) that earlier in
is century there was in Protestant theology and pastoral
ictice a gaping "vacancy" here which urgently needed
be "filled." The issue I wish to discuss is not the
acancy" — that has been only too painfully real — ^but
e question of whether the way in which it has been
d is being filled is sound. I do not ask for less religious
ncem and effort for troubled persons but for more, of a
ierent and, hopefully, better kind.

I.

In January of 1926, a then little-known man by the
me of Anton T. Boisen published in Christian Work
. article which has drastically modified theological edu-
pon and changed church history. It was entitled "The
[lallenge to Our Seminaries," and its salient thesis was
at "in mental disorders we are dealing with a problem
liich is essentially spiritual" (p. 8). Said Boisen:

But of any such possibilities the Church is utterly ob-
ivious. She takes no interest in cases of pronounced mental
iisorder. . . . We have therefore this truly remarkable situa-
tion — a Church which has always been interested in the
pare of the sick, confining her efforts to the types of cases
physical illness] in which religion has least concern and
east to contribute, while in those types in which it is impos-
;ible to tell where the domain of the medical worker leaves
iff and that of the religious worker begins, there the Church
s doing nothing (p. 9).

Since Fundamentalism preached only a hell to come
d liberal theology preached no hell at all, both, argued
tisen, were "blind to the hell which is right before our

JS."

When we remember that what we know today about the
luman body has come very largely through the study of dis-
:ase conditions, is it any wonder that a Church which has
completely ignored the problem of the soul that is sick,
s able to speak with so little authority concerning the laws
)f the spiritual world? (p. 10).

62 The Crisis in Psychiatry and Religic

Boisen's plea, therefore, was that the seminaries sts;
sending their students to mental hospitals for an "i
ternship" of a few months or a year.

For we have here a problem which must be studied frc
real life and not from books. It is, moreover, absolutely
sential to have the co-operation of medical men, for hci
the provinces of religious and medical workers overlap, a;
the medical worker is now in possession of the field. T]
religious worker is a mere beginner, and he must be v(J
careful not to embark on any half-attempt at "soul-healini

(p. 11). I

In this way the young minister, upon leaving t
seminary, would be able to bring "a new religious p:^
chology" to the people, so that "the Church may od
more come into its own and speak no longer as t'
scribes and Pharisees and interpreters of traditions l
with the authority of the knowledge of the laws of t
life that is eternal" (p. 12).

II.

The impact of this article and others of a simi
nature was such that young theologians soon began goi
to mental hospitals for the type of internship which I
Boisen recommended; and by 1930 the ''clinical mo
ment" had gained sufficient momentum to warrant 1
formation of The Council for Clinical Pastoral Traini:
to be followed in 1944 by another organization cal
The Institute for Pastoral Care. Niebuhr, Williams, a
Gustafson, in their 1957 book on The Advancement
Theological Education, comment upon these deveL
ments as follows:

These two programs have between them initiated i
been responsible for a considerable part of the clinical tr;
ing of pastors for twenty -five years. Many schools have m
use of these programs or devised similar ones (p. 123).

The growth of this program is shown by the follow
data. In 1943 thirteen seminaries were related to some k
of clinical training program. Nine years later in 1952 tt
were forty- three schools. Reports made to the present st
indicate that about three-fourths of the accredited seminai
one- third of others, had either developed clinical trair
programs of their own by 1955 or sent students to
Council or Institute for such training (p. 124).

HALLENGE TO OuR ChURCHES: I. ThEORY 63

. . . the close connection between the traditional disci-
pline of "pastoral theology" or "care of soul" and the psy-
chological approach to human personality through first-hand
experience of human problems is widely recognized today,
and has given rise to one of the most influential movements
[in theological education, the emphasis on the preparation of
the Christian pastor as counselor (p. 122).

There is, of course, no need to document extensively
e contrast between the situation in 1926 and now as
r as the resurgence of religious interest in personality
sturbance is concerned; it is immediately apparent to
yone who has been a church member during this
riod, and only a little less so to others. However, there
p signs of acute unrest and tension in this area, both

the churches and the seminaries; and it will be our
ijective in the remainder of this article to expose the
eoretical issues here involved and, in the sequel to
is discussion, to suggest a different practical approach

the whole problem.

III.

Not only did Anton Boisen, in his early articles, show
e urgency of renewed religious interest in the mentally
; he also, in 1936, published a highly readable and
rceptive book, The Exploration of the Inner World,

which he outlined the theory of psychopathology
lich he believed most congruent with the great insights

religion and most likely to lead to more effective
evention and treatment. Elsewhere [see Chapter 2]
lave reviewed Dr. Boisen's original conceptual scheme

detail. Here a few brief excerpts from his book will
tch the tenor of this thinking:

The form of psychotherapy now most in the public eye
is psychoanalysis. This in its aims is the exact opposite of
faith healing. It has often been compared by its proponents
to surgery, and major surgery at that. It is an attempt to
' lay bare and bring into clear consciousness the disowned sex-
ual desires and cravings which it assumes have become de-
tached from the conscious self and are responsible for the
s' neurotic symptoms. Its aim is to make over the harsh con-
* science and the rigid ethical standards which have led to
^ the disowning of these sex cravings so as to permit of their
3 incorporation in the personality. To this end the psycho-
analyst tries to get his patient to live through again his

64 The Crisis in Psychiatry and Religiob

early experiences. The entire procedure is designed to detach
the patient from his early loyalties in order to enable hiq
to build up a new philosophy of life in which the dissociatec
cravings may be properly assimilated (pp. 243-44).

In all my efforts [as a hospital chaplain and therapist] '.
rely upon a simple principle ■ derived from my theologica
training which seems to me far too little understood. I refe
to the view that the real evil in mental disorder is not to h
found in the conflict but in the sense of isolation or estrange
ment. It is the fear and guilt which result from the presena
in one's life of that which one is afraid to tell. For this rea
son I do not consider it necessary to lower the consciena
threshold in order to get rid of the conflict. What is neede(
is forgiveness and restoration to the fellowship of that socia
something which we call God (pp. 267-68).

I would furthermore [suggest] that our findings indicafc
that the sense of guilt, the self-blame and the emotional dij
turbance which accompany it are not themselves evils bu
attempts at a cure. The real evil is the failure to attain th
level of adjustment called for in some new period of develop
ment and the short-circuiting of the vital energies througl
easy satisfaction (p. 281).

IV.

In retrospect, we now know that the foregoing wer
prophetic words. But they were not heeded. Instead, th-
basic assumption of Freudian psychoanalysis — namel}
that psychoneurosis arises, not from moral weakness o
failure, but from an excessive and irrational severity (o
"disease") of the superego or conscience — gradually pei
meated and possessed the pastoral counseling movemeni
One of the earliest and most transparent indications o
this victory of the Freudian view, as opposed to tha
advocated by Boisen, was the appearance in 1943 o
Harry Emerson Fosdick's book. On Being a Real Persori
Intended for laymen as well as religious leaders, thi
book achieved an immediate popularity and widespreai
influence.

In a chapter entitled "Handling Our IMischievous Cor
sciences," Fosdick made his position clear:

Indiscriminate praise of conscientiousness is psycholog
cally dangerous. Many people worry themselves into coir
plete disintegration over moral trifles, and others have cor,
sciences so obtuse that they can get away with anything (|!
133). I

Challenge to Our Churches: i. Theory 65

Conscience is a tricky function of personal life . . . with
equal facility it makes saints, lunatics, and bigots (p. 133).

Following one's conscience can be a distracting experience,
and numberless people are torn to pieces by it (p. 134).

We are supposed to sail by conscience and yet we cannot
trust it; instead of relying on the compass to keep our
course straight, we must keep our compass straight, and that
makes nervous sailing (p. 135).

Far from solving the problem of conscience, however, the
acceptance of it is often only the beginning of our difficulty.
Many do accept their consciences. They are disastrously con-
scientious. . . . The psychiatrists' offices fill up with people
whose consciences are on the warpath, harassing them with
worry and remorse over small scrupulosities (p. 143).

The mischief is that conscience can take advantage of its
importance and can overbid its hand. . . . No good can
come from this plus-activity of conscience, this hang-over of
remorse; it spoils the life of the sufferer and darkens the
skies of his family and friends. When conscience has fulfilled
its function it ought naturally to stop, but commonly it
persists, torturing its victim long after the torture has lost
all value (p. 147).

Moralism deals with symptoms and condemns results; psy-
chotherapy diagnoses causes and is concerned with cure (p.
152).

Conscience makes multitudes of people miserable to no
good effect (p. 153).

That we need more conscientious people is a platitude,
common but highly questionable. An immense amount of
conscientiousness does more harm than good (p. 157).

Although Dr. Fosdick conceded that behind some
'morbid conscientiousness" and apparent scrupulosity
iiere may be real guilt, he stoutly maintained — and in
;o doing capitulated to the primal psychoanalytic premise
—that in many other instances conscience is a real mon-
>ter which complains and tortures the individual without
just cause.

V.

In September of 1943, shortly after the publication of
On Being a Real Person^ Dr. Boisen wrote Dr. Fosdick
expressing his admiration for and appreciation of many
reatures of the book but deploring its acceptance of the
preudian doctrine of superego over-severity. Said Boisen:

The statement on page 154 that the censorious con-
science that can be blighting when used on others can have

'^

66 The Crisis in Psychiatry and RELIGIO^

a similar effect when used on oneself is undoubtedly true; nol
so, however, the statement on page 152 that self-condemna
tion is often the most misleading fact that can intrude itself.
My observation is that the patient who condemns himself,
even to the point of thinking he has committed the un-
i V': pardonable sin, is likely to get well. It is the patient who
'^ \ blames others who does not get well. The one is a benign
^^3 reaction, the other a malignant one. Self -blame, even when
^^ it leads to severe psychosis, means the recognition that some-
thing is wrong and the acceptance of one's responsibility for
the difficulty. The emotional disturbance which follows is;
then analogous to fever or inflammation in the body. It is
not an evil but a manifestation of nature's power to
heal. . . .

For example, take the hypothetical case you describe on
page 150. You refer to the sense of guilt manifested by
this young man as a "needless and harmful intruder." If
the young man in question were like most of those I have
known, the pent-up volume of guilty fears would be instru-
mental in driving him to the minister's study and the relief
he found there would come not so much thru anything the
minister said to him as from what he said to the minister
about a problem which for him was by no means a minor
matter.

I wish that you might have done more toward clarifying
the nature and function of conscience. Our psychoanalysts
have discovered it and have much to say about it, but from
my point of view their theories are far from adequate, while
Dewey and Mead and Hocking are not given their rightfuli
due. j

In an article entitled ''Niebuhr and Fosdick on Sin,"!
which appeared in the Chicago Seminary RegisteVj for!
March, 1944, Boisen repeated and elaborated these con-
cerns. However, he was unable to stenj the tide; and the
Freudian notion that man sickens, not from sin but from
excessive conscientiousness, continued to gain acceptance
in theological circles.

VI.

As already noted, there is tension today in our semi-
naries and churches regarding the Freud-Fosdick position;
but this position is clearly in the ascendancy, officially.
Millions of ordinary church members have never accepted
it, and many individual ministers and seminary teachers
likewise deeply distrust it. But it has seemed that *'sc]h

Challenge to Our Churches: i. Theory 67

ence" was against them, and they have been reluctant
to speak out for fear of ''contradicting science"; whereas
those who beheved they were on the side of Psychological
Truth have been boldly vocal. Their outspokenness could
be illustrated at great length; but two recent examples
will suffice. Dr. Carl Michalson, a professor of theology
at Drew University, in the chapter on guilt in his Faith
for Personal Crises (1959), writes as follows:

Yes, the conscience (populady conceived) is as ready to
condemn us as our most malicious enemy would be. Our
conscience is a "prattler," bent less upon our regeneration
than upon our destruction. ... It is our executioner, bent
upon our destruction, only confirming our lie about ourselves
and hiding from us the truth that we are in God's image,
made to be responsible not to our conscience but to Him
(p. 59).

Christians are often scandalized by psychotherapists who
seem to relax the moral standard in order to relieve the
tension of their client's anxious guilt. The psychotherapist in
this instance is a better interpreter of righteousness than
many Christians are. . . . Moral flexibility may not in itself
be healing but it does less damage than the tightening of
the demands which are already cracking one's nature. There
are times when aspirin is more healing than action. This
is the gospel truth in "the power of positive thinking"
(p. 61).

And The Reverend George Christian Anderson, Direc-
tor of the Academy of Religion and Mental Health, in
the first chapter of his book Man's Right to he Human,
echoes this now familiar refrain. He says:

Today, psychiatry and the new sciences of behavior compel
us once again to examine the precepts by which we live,
shocking and enraging those whose houses were built on the
foundations of their fathers (p. 15).

We are now beginning to ask whether our wrongdoing
is sin or caused by emotional illness. . . . Health of mind
depends on whether we can let these forces ["powerful needs
for love, raging hostility," p. 19] come out without feeling
excessively guilty or frightened by what erupts from within
(p. 17).

The psychological journey into our inner world [by means
of psychoanalysis] helps us to experience our emotions
without fear, to admit what we have denied, and to deny
what we once believed. Psychiatry obviously must reveal our

68 The Crisis in Psychiatry and Religion

morals, and measure the strength of the consequences of our
rehgious faith (p. 18).

VII.

Quite aside from the palpable desertion of traditional :
Christian ideals and precepts which all such writings
represent, there is the additional — and not inconsiderable
— complication that secularists and scientists are them-
selves now busily re-evaluating the whole Freudian Weld-
anschauung.

In the book first published in German in 1938 and
subsequently (1950) in English, with the title Technique
of Analytical Psychotherapy, Wilhelm Stekel, an erst-
while Freudian, wrote:

I contend that orthodox analysis has reached a crisis
which betokens that the end is near, that collapse is ap-
proaching (p. xxiv).

And after reviewing many case histories in which it is
apparent that real guilt, rather than a mere "guilt
complex," was at the basis of the manifest morbidity,
Stekel concluded:

I have had many cases of the kind, but have merely
selected a few to show that parapathic [neurotic] disorders
may be diseases of the conscience [in a new sense]. The
patient suppresses his remorse, tries to drown the voice of
conscience, and feigns immunity. Nature takes vengeance
(p. 327).

And more than a decade ago, quite unaware of the
work of either Boisen or Stekel, the present writer (1950)
was forced to take the following position:

In essence, Freud's theory holds that anxiety comes from
evil wishes, from acts which the individual would commit
if he dared. The alternative view here proposed is that
anxiety comes, not from acts which the individual would
commit but dares not, but from acts which he has com-
mitted but wishes that he had not. It is, in other words, a
"guilt theory" of anxiety rather than an "impulse theory*
(p. 537).

What is the situation, in psychology and psychiatry,
today? In another connection [Chapter 1], I have re-
viewed prevailing psychiatric opinion concerning psycho-

Challenge to Our Churches: i. Theory 69

analysis, typical of which is the following statement by
Dr. Lawrence Kubie (1956):

We [analysts] have no right to be for or against anything
in this field. We have a right only to the most complete
humility — humilit}' that says we still know practically nothing
about many important elements in the neurotic process or
in the psychotherapeutic process (p. 103).

Also in 1957, at its annual convention, the American
Psychological Association, for the first time in its his-
tory, sponsored a symposium on "Religion and Mental
Health"; and in September, 1959, the same organization
lield a symposium on 'The Place of the Concept of Sin
in Psychotherapy" which attracted nation-wide attention
[Chapter 3].

VIII.

If theologians will take the trouble to examine care-
Fully what is thus happening in the secular professions
and sciences on which they have so heavily drawn for
their new Psychology, they will find that something like
1 revolution is in progress, which leaves them clutching
Freudian doctrine to their breasts without either biblical
or solid scientific support for it. The situation is well
mmmarized in a paper ("Are Psychoanalysis and Reli-
gious Counseling Compatible?") which the New York
psychologist, Lee R. Steiner, read at a meeting of the
Society for the Scientific Study of Religion, held in
November, 1958, at Harvard University:

It is my impression from twenty years of study of where
people take their troubles and why tfiey seek out the sources
they do,^ that the ministry makes a tremendous mistake
when it swaps what it has for psychoanalytic dressing.
Through the ages the ministry has been the force that has
at least attempted to keep morality alive. It would be a pity
if, in one of the eras of greatest moral crisis, the clergy
should suddenly abandon its strength for something that has
no validity, no roots, and no value. It is my impression that
they would do far better to cling to what they have. Judaism
has endured for almost 6,000 years. Christianity for almost
2,000. Where will psychoanalysis be even 25 years from
now? ... I predict that it will take its place along with

^ See Steiner (1945), Where Do People Take Their Troubles?

70 The Crisis in Psychiatry and Religion

phrenology and mesmerism. Like them, psychoanalysis was
the brain child of a highly inventive scientist, who was
completely sincere in his belief that he was opening up a
new world. We shall respect Freud for his efforts, as we do
Gall and Mesmer. Like them, Freud had the germ of an
idea which flared into a way of life for a time, but then i
vanished.^

Today we can no longer honestly accept Freud as the j
prophet which many theologians have tried to make of i|
him. Instead, he is the Pied Piper who beguiled us into i|
serious misconceptions and practices. In the sequel to-
this article, I shall try to suggest ways in which the j
churches and seminaries can recover lost ground in this I
area and build for a sounder future.

^ Cf . Dallenbach (1955).

i

The New Challenge to our Churches

and Seminaries:

II. The Problem of Action*

Here is a preliminary attempt to go beyond analysis
and become action-oriented, to prescribe rather than
merely diagnose. Any projected practical program always
has to be tempered by circumstances and on-going ex-
perience, but the two suggestions made herein are at
least promising beginnings. A friend in Educational Ad-
ministration used to be fond of saying that action in a
practical situation is never straight-ahead-according-to-
blan. It is always somewhat opportunistic, a slight advance
here, an unexpected development or opportunity there.
But movement can occur if there is a clear goal and
steady pressure towards it.

In I960 the World Council of Churches announced
a conference on ways of revising and revitalizing religious
worship — a subject implementing the concerns expressed
in the following chapter. In March, 1960, the ministers
of the First Community Church of Columbus, Ohio,
held the first of a projected series of workshops on new
ways to use religion, in conjunction with psychology and
social science, to "remove blocks to personal growth." A
little later the National Council of Churches held a con-
ference, with several secularists participating, on the place
of religion in higher education. These developments are
representative of a new ''openness" to explore and change,
if we can only lay hold of a sound and dependable ra-
tionale.

In Chapter 12 we shall go more deeply into some of
the suggestions which are made in this chapter {see also
Chapter S).

In Part I of this article [Chapter 6], I have traced the
brief history of the pastoral counseling movement and

* Published in Foundations: A Baptist Journal of History
and Theology, October, 1960, 3, 335-347.

71

72 The Crisis in Psychiatry and Religion

have shown it to have had four stages: (1) that of grow-
ing awareness (on the part of Boisen, Fosdick, and
others) of the failure of early 20th-century religion to
speak and minister to man's psychological and emotional
needs; (2) the initiation of the pastoral-counseling, or
"clinical," movement (largely through the work of
Boisen and his students) and Boisen's efforts, epitomized
in his 1936 book, The Exploration of the Inner World,
to give this movement a conceptual framework which
would be congruent with the traditional Judeo-Christian
ethic; (3) the blighting of this aim by the intrusion of
the Freudian doctrine that human beings sicken in mind
and soul, not from sin, but from their very excess of
piety (or "moralism"); and (4) current developments
in the sciences and secular professions which are casting
grave doubt upon the validity of the Freudian view and
thus placing many contemporary clergymen and semi-
narians in the awkward position of having "sold their
birthright."

It now appears that Boisen was right, that psycho-
pathology is a moral problem, through and through, and
that it has gravitated into medical hands by default and
complacency on the part of the Christian ministry and
churches. Recently a church woman in Massachusetts
wrote me a letter which she concluded by saying, "Cer-
tainly if these ideas gain general acceptance, psycho-
therapy would be revolutionized." On the assumption,
substantiated in the earlier article, that these ideas are
"gaining acceptance," we shall here explore some of
the implications which follow for courses of action
which our churches and seminaries can pertinently con-
sider and, hopefully, pursue.

I.

In the preceding article, I have called attention to
Dr. Boisen's 1926 article, "The Challenge to Our Semi-
naries," in which he urged seminary students to do an
internship in a mental hospital in order that they might
bring "a new religious psychology" to the people and
that "the Church may once more come into its own and
speak no longer as the scribes and Pharisees and inter-
preters of traditions but with authority of the knowledge
of the laws of the life that is eternal" (p. 12). And I
also cited the recent Niebuhr-Williams-Gustafson report

Challenge to Our Churches il Action 73

on The Advancement of Theological Education to show
how widely this admonition is now being followed. But
this new "clinical" program has been deflected from the
course Dr. Boisen originally conceived for it and has
taken on a strongly Freudian and neo-Freudian colora-
tion. This, quite understandably, has created an uneasi-
ness in our seminaries, which, however, has remained
muted and is only now beginning to come out into the
open. For example, in the report just cited, the authors
guardedly say:

Firsthand experience with persons in trouble is the basic
material out of which Christian skill in care of souls must
come. . . . Yet in spite of the ease with which this field
can lead out and away from its theological center, there is
a strong determination in the schools to keep the psycho-
logical approach to personality in close relation to the
Church and its faith. There is indeed considerable tension
within some schools on the place of this field in the cur-
riculum (p. 122, italics added).

Clinical training programs need the schools not only for
students and financial support but also as a source of con-
structive criticism (p. 125, italics added).

The pitfall is that [the student] may begin to "psycholo-
gize" everything and try to solve every problem of faith
through psychological analysis (p. 127).

II.

The present situation is, I believe, a very serious one
and far from what Dr. Boisen originally intended. During
the clinical internship and in propaedeutic seminary
courses, students are typically schooled in the view that
psychopathology is only indirectly a religious concern.
They are deeply indoctrinated with the view that neu-
rosis and psychosis arise from too much ''morality,"
rather than too little, and that the minister must care-
fully recognize his "limitations" in dealing with such
problems.

The total impact of this experience has, it seems, not
been a good one. Typically, the student returns to semi-
nary either confused, by the manifest contradictions
between his religious heritage and psychological and
psychiatric doctrines, or with the feeling that here, in
psychiatry and psychology, is a redemptive ("therapeu-
tic") power exceeding anything that religion itself can
offer. The result is that if and when the seminarian, as

74 The Crisis in Psychiatry and Religion

parish minister, later undertakes pastoral counseling, it is
with the feeling that his ''psychological methods" are
something apart from his theology and Christian faith
and that he can, at best, deal only with persons whose
difficulties are relatively superficial. He is carefully in-
structed, both by members of the secular healing profes-
sions and by his own supervisors, on the importance of
''knowing when to refer." In his own eyes as well as those
of others, he is clearly a second- or third-class operator
in this field; and even Niebuhr, Williams, and Gustafson
bow to this prevailing state of affairs, when they say:

We must add the warning that the student needs to
learn the kinds of problems which require medical attention
and which as pastor he should not try to handle. His minis-
try is to the person in his religious need (p. 128).

Has this type of program indeed taught our clergy to
speak with authority, or as the scribes and Pharisees? ^

III.

How ingrained the "psychiatric" view has become in
the minds of many of our clergymen is reflected, with
special clarity, in Anderson's recent book (also cited in
the preceding article) entitled Man's Right to Be Hu-
man, with the equivocal subtitle. To Have Emotions
Without Fear. Here the stock position is reiterated, thati
the psychologist, psychiatrist, psychoanalyst, social worker |
— indeed, almost anyone — is better equipped to deal with
serious emotional problems than is the minister. If, as
we now have reason to believe, all psychopathology (of
the functional varieties) stems from moral failure, how
fantastic all this is! And yet many ministers have what
may be termed a "trained incapacity" and educated
reluctance to really come to grips with the problem of
mental illness. Instead, they dutifully "refer," as indicated
in the following excerpts from the book just cited:

It was evident that Joe was suffering from a serious
neurosis. As soon as Joe was gone I picked up the phone

^ In an attempt to escape the pall of psychological and
medical domination in this area, there is now a tendency on
the part of some writers to speak of Pastoral Theology, rather
than of Pastoral Psychology or Pastoral Psychiatry. But it is
doubtful if a theological emphasis is so much what is needed
as a sounder, more defensible psychological one, although it
is realized that a valid absolute distinction here is not possible.

Challenge to Our Churches n. Action 75

and called a psychiatrist I knew and explained the situation.
He agreed to see Joe the next day. ... I was able to make
her [Joe's sister, with whom he lived] see that Joe was not
as immoral as he was sick, and that he needed love and under-
standing, and medical care, too, more than ever (p. 141).

''Most men are beasts; only my Lord in heaven is worthy
of my purity," she continued. I suggested that she come
see me again, but in the meantime I referred her to a
clinical psychologist for some vocational tests. ... It was
obvious that the young woman was handicapped by a severe
neurosis involving excessive guilt concerning her sexual feel-
ings. Inasmuch as psychotherapy was indicated, the girl was
referred to a psychiatrist who was able to help her accept
her sexuality in a healthy manner (p. 172).

A man came to see me about his wife's growing coolness
toward him. . . . After counseling with both of them in-
dividually, I discovered that the wife really loved her husband
very deeply even though she abhorred his sexual claims. I
referred both of them to a psychiatrist for further profes-
sional help (p. 176).

This is typical of what is supposed to be "good prac-
tice" in the ministry today. And not long ago a young
clergyman who had just come to our community informed
me that he had been advised, in seminary, not only to
be sure to "know when to refer" but also to be very
careful in his sermons not to say anything that would
make anyone "feel guilty." People have too much guilt
already, he had been told; and if you talk about sin and
guilt and moral responsibility from the pulpit, you only
increase the danger of "neurosis." I wonder if this young
man's professors know these lines from page 109 of T. S.
Eliot's play, The Elder Statesman:

You think that I suffer from a morbid conscience,
From brooding over faults I might well have forgotten.
You think that I'm sickening, when I'm just recovering!

IV.

What the average theologian and religious worker ap-
parently does not know and is reluctant to recognize is
the extent to which the system of concepts and practices
in which he has been schooled, during his training in
pastoral psychology, is today in a state of deterioration
and impending collapse. From the standpoint of those
of us who know these developments from the inside.

76 The Crisis in Psychiatry and Religion

it is tragic to see the clergy continue to pay homage to
what, in reahty, is rapidly becoming a hollow shibboleth. I
For more than a decade, now, I have been pointing to
the logical and empirical incongruities in psychoanalytic
theory, on which so much psychiatry and clinical psy-
chology is directly or indirectly founded; and in addition
to my already published books and articles in this field,
I invite the reader's attention to various reprints and
mimeographed papers which will be supplied upon re-
quest [now assembled as the chapters of this book].

But in these misgivings concerning psychoanalysis and '
the sense of untapped potential within the great tradi-
tions and insights of religion itself, I am by no means
alone, as has been indicated in the preceding article.
And to that line of evidence I wish now to add further '
testimony of failure on the part of that profession in I
which theologians have placed such supreme faith. Re-^l
cently I was talking to a supervising psychologist in the I
Veterans Administration who expressed the most pro- !
found disillusionment with prevailing psychotherapeutic
methods and referred to VA mental hospitals as "sick
institutions." And Dr. H. C. Solomon had this to say
in the 1958 presidential address to the American Psy-
chiatric Association:

Large mental hospitals are antiquated, outmoded, and
rapidly becoming obsolete. We can still build them but we
cannot staff them; and therefore we cannot make true hos-
pitals of them. ... I do not see how any reasonably objec-
tive view of our mental hospitals today can fail to conclude
that they are bankrupt beyond remedy. I believe therefore
that our large mental hospitals should be liquidated as
rapidly as can be done in an orderly and progressive fashion

If my description is correct and my projections reasonably
accurate, a new attack on the "care and custody" of the
long-term ill must be attempted. Unpalatable as it may
appear, one must face the fact that we are doing little by
way of definite treatment of a large number of our chronic
hospital population. It is not even the case that we are
providing them with first-class environmental care, much less
loving and tender care. Therefore, I suggest we take a new
look at the problem (p. 8).

Somewhat parenthetically and without elaboration,
Dr. Solomon observes:

Challenge to Our Churches ii. Action 77

Our young physicians specializing in psychiatry are not
heading toward our large hospitals, nor are the other cate-
gories of personnel. In many of our hospitals about the best
that can be done is to give a physical examination and make
a mental note on each patient once a year, and often there
is not even enough staff to do this much (p. 7).

Despite government-sponsored subventions and schol-
arships, the men and women who are today being trained
in psychiatry are not going into state and VA mental
hospitals for one major reason. It is not that the need
is not great; they can make more money in private
practice! There are, to be sure, some dedicated and
idealistic psychiatrists and clinical psychologists. But the
plain fact is that professional psychotherapy is, in general,
iJ business; and if it turns out that what the patient
jjecretly hopes to buy (and the therapist implicitly prom-
ises to sell) is a cheap form of forgiveness and expiation
![cf. Chapter 10], the "therapeutic" transaction is a very
dubious business^as Katie Lee slyly implies when she
ings (in "Shrinker Man"):

I've been on one of those "complex" tours;
I want you to make my problems yours.
Now gimmie one of them cut-rate cures,
Shrinker Man!

Can an enterprise that thus measures in dollars and
-ents its efforts to minister to sick minds and souls
continue indefinitely to command our respect and con-
idence?

V.

If we have now accurately diagnosed the difficulty,
vhat's to be done about it? In the over-all and ultimate
;ense, I have to say that I do not know. Certainly the
otal situation calls for courage, social inventiveness, and
nsights which I do not possess. But I do have two sug-
jestions to make.

I think we now have to recognize that Protestantism
las, on the whole, handled the problem of guilt very
)adly and that the present critical situation is a natural
;ulmination of four centuries of bumbling, indecision,
.nd confusion on this score. As a first step, therefore,
oward rectifying our predicament, I believe our churches

78 The Crisis in Psychiatry and Religion

ought, as Harry Emerson Fosdick argued (somewhat
inconsistently) as early as 1927, to return to the practice
of confession. We have tried to ignore and by-pass the
very notion of guilt and sin; but it won't work. The
gospel of sin and salvation (redemption) is not one of
bondage but of liberation, hope, and strength; and we
must, I believe, return to it in all seriousness.

Pastoral counseling, as presently practiced, is, to be
sure, itself a form of "confession," but it has two major
weaknesses: (1) it is episodic, voluntary, and often
belated and therefore lacks the preventive function which
regular, prescribed confession (when practiced con-i
scientiously and earnestly) has; and (2) "counseling"
is now very largely patterned on secular psychotherapy,,
with its emphasis on "acceptance" and "insight," and
does not take sin really seriously. People do not merely,
"talk" themselves into sin; they act. And by the same|
token, I do not believe anyone ever talks himself out
of sin. Again there must be action, and this action musti
involve not only confession, of an ultimately open type,
but also "atonement." Confession without a sober pro-
gram of expiation can be dangerous, in the sense oi
causing the individual to be overwhelmed with guilt andj
self-hatred. And this is one of the unrecognized factors!
that makes many present-day religious counselors soi
insecure and unconfident. But if we can only understand!
man's true "condition," ways will be found to overcome
the apparent obstacles [see later chapters]. |

VI.

My other suggestion has to do with a possible change
in emphasis in the "missionary" concern of our churches
and the problem of staffing our state mental hospitals,
which has already been alluded to.

The legal and social climate being what it is at present,
clergymen are justifiably afraid to try to go "all the
way" with emotionally disturbed persons. Sometimes
it is virtually inevitable that an individual pass through a
psychotic interlude (for reasons already mentioned) on
his way to personal transformation and recovery. It is,
of course, not uncommon for psychiatrists themselves tc
have in treatment patients whom they eventually have
to commit to mental hospitals. But if a person is seeing

[Challenge to Our Churches n. Action 79

1 religious counselor and becomes actively psychotic, the
:ounselor is immediately vulnerable. He made the person
^orse; he should have referred the patient; etc., etc.

In an attempt to find a solution to this intolerable
)ituation, a few denominations are experimenting with
nental hospitals of their own. Without state support,
these are, of course, extremely expensive to operate; and
)uch reports as I presently have indicate that even these
institutions rather pride themselves on the fact that they
ire conducted along "approved psychiatric lines," rather
than with any great new insight born of religious precept
md conviction.

Alternatively, I would like to see our chu'-^hes take
mental hospitals as a major object of missionary effort.
[sn't it a little awkward for us to be so concerned about
the benighted state of those in foreign lands when the
size and condition of our "insane asylums" stand out
like great festering sores on the conscience of our own
nation? I know a state mental hospital (not atypical)
with, a population of 4500 patients without a single
trained psychiatrist on the staff. Such physicians as there
are, are immigrants or have for some other reason com-
monly failed to obtain a state license for general medical
practice. And there is one Protestant chaplain and one
Catholic priest for this "town," where the religious and
spiritual needs are surely far greater than in a normal
community of comparable size.

So why not let the churches also start at the other
end of the line, with persons who have already hit bot-
tom; who are in a protected environment, where the
only direction they can move is up? Here the religious
worker can be associated with a person's rise, rather than
his fall. And imagine the gratitude, loyalty, and enthu-
siasm which would be generated in persons who felt that
religious insights and practices had saved them from the
hell of mental illness!

Elsewhere [Chapter 2] I have argued, with Boisen,
that in neurosis and psychosis the afflicted individual is
in a moral and spiritual crisis, and that in no other
circumstances does the experience of God become such
a vivid reality. (See also Frederick West's book. Light
beyond Shadows!) But the common perception is that
so-called mental "illness" really is an illness and has

80 The Crisis in Psychiatry and ReligionI

nothing to do with either God or the Devil. Is this
progress or one of the greatest popular fallacies of all
time? Can it be that we have come to doubt the very
existence of Cod because we do not know where to
look for Him and how to recognize His most tangible
manifestations? ^ If churches today made a determined
effort to come to grips with the problem of mental illness
in this country, they could not only perform a great
human service; they would also, I predict, discover a new
and vitalizing force which will forever elude them at the
more superficial levels of religious ritual and observance.
As a friend of mine, who is a psychiatrist but also ac-
tively religious, recently remarked, "Unless you face the
demons, you never hear the angels!"

^Cf. Robinson (1928).

i

8

Psychopathology and the Problem
of Guilt, Confession, and Expiation*

If any one chapter is nuclear to this book as a whole,
it is the present one. Here we come to grips, empirically ,
with the question: Does psychopathology involve real
or only "imaginary" guilt? If the psychoneurotic' s guilt is
not real, the whole argument collapses. If it is, then the
necessity for a long and complicated series of ideological
and institutional changes weighs heavily upon us.

Some readers, upon completing this chapter, may feel
dissatisfied at the absence of any effort to provide a
formal definition of ''real" guilt, sin, evil. Concern with
this problem will come in due course. But what is more
immediately important, it seems, is to get some feel for
the raw data. Without a strong sense of the pragmatic
and factual, definition making can be both tedious and
sterile.

The case material and other clinical evidence here
cited is not, of course, submitted as definitive ''proof"
of a universal or absolute principle but only as illustrative
of a possibility. Already there is a decided inclination to
concede that real guilt can be determinative in person-
ality disorder. The question is whether it always is. The
present writer is entirely willing to leave the answer to
this question open, pending further research and expe-
rience. But even if guilt is real {rather than illusory)
in only half or a third of all personality disturbances, it
still constitutes an enormous practical problem, with

* In addition to serving as the first of the E. T. Earl Lectures
at the 1960 Pastoral Conference sponsored by the Pacific
School of Religion, February 23-25, in Berkeley, California,
this paper was read before the St. Louis Society of Neurology
and Psychiatry, April 1, 1958, and at the Symposium on
Current Trends in Psychology held by the University of Pitts-
burgh, March 12-13, 1959. It has also been pubhshed ir»
Current Trends in Psychology, X, University of Pittsburgh
Press, 1960.

81

82 The Crisis in Psychiatry and Religion

which neither the churches nor secular professions are
presently dealing at all adequately. And if it should
turn out that real guilt {however disguised or displaced)
is the chief etiological factor in all psychopathology^ the
situation will be still more disconcerting and challenging.

Historically the prevailing view, in literature and non-
literate societies alike, has been that man sickens in
mind, soul, and perhaps even body because of unconfessed
and unatoned real guilt — or, quite simply, from what
an earlier era knew as a state of ''disgrace" or "sin."
However, as a result of complicated historical reasons
which have been explored elsewhere [Chapters 9 and 11],
this view has, in our time, fallen into disrepute. The
church, badly weakened by internal strife and injudicious
opposition to science, quietly relinquished its traditional
claim to competence in the domain of the sick soul and
unprotestingly accepted the emphasis of 19th-century
psychiatry on constitutional and biochemical factors.

It was, therefore, in this remarkable setting that
psychoanalysis had its inception and rapid growth. As
Freud observed in his autobiography (1935), toward the
end of the last century there were, in every large European
city, "crowds of neurotics, whose number seemed further
multiplied by the manner in which they hurried, with
their troubles unsolved, from one physician to another"
(p. 27). The church had, in effect, turned a deaf ear to
the needs of these people; and the common forms of
medical and psychiatric treatment, which were predicated
on a somatic conception of personality disorder, were
I magnificently ineffective. The situation thus called for a
' boldness which Freud supplied in the form of a clever
compromise between the traditional moral view of per-
sonality disturbance and medical preconceptions. Cuilt,
he hypothesized, was indeed a factor in neurosis but it
was a false, unrealistic, and crippling guilt which, as a ,
result of a too strict and restricting socialization of the
individual, impeded the normal flow of certain instinctual
energies, notably those of sex and aggression. So the
psychoanalytic physician set out to cure neurotic individ-
uals by championing the rights of the body in opposition
to a society and moral order which were presumed to be
unduly harsh and arbitrary.

Guilt, Confession, and Expiation 83

There was, of course, no lack of individuals who were
willing to be saved by this plausible-sounding and pleas-
ant philosophy — and who were willing to pay for it,
handsomely. Thus, both patients and practitioners of the
art were assured. But the day of reckoning is upon us.
Our mental hospitals are now, alas, full of persons who
have had this new form of treatment and not profited
from it; and among them, their erstwhile therapists, and
the general public alike there is growing disillusionment
and alarm. Once again we are in a period of sober reap-
praisal; and it is the purpose of this paper to suggest
one way of re-thinking the problem which, although in
some respects very costly, nevertheless promises a form
of redemption more radical and generally applicable than
anything we have known in the recent past.

As the title of this paper implies, it will be our plan
to consider, first, the possibility that in psychopathology
guilt is real rather than illusory ("delusional"); then we
shall explore the correlative proposition that the aim of
communication and self-disclosure in the therapeutic sit-
uation is not mere understanding and insight (in the
Freudian sense of these terms) but a changed, repentant
view of oneself; and finally we shall examine evidence
for believing that, however necessary they may be, con-
trition and confession are not alone enough to restore
psychic and moral equilibrium and must be followed by
meaningful, active forms of atonement or restitution.

I. HOW REAL IS THE NEUROTICUS GUILT? —
A QUESTION OF FACT

Freud held that, as a result of a too intensive socializa-
tion, some individuals develop so great a fear of their
sexual and hostile feelings that, eventually, they even
deny these feelings access to consciousness and that it is
the alarm which the ego feels when these impulses clamor
for recognition and expression (i.e., the danger, as Freud
called it, of the ''return of the repressed") that generates
the characteristic neurotic affects of depression, anxiety,
and panic. In 1950 the present writer (see Chapters
18-22) hypothesized that in neurosis it is actually the
individual's conscience that has been repudiated and
"repressed" rather than his "instincts," thus shifting the

84 The Crisis in Psychiatry and Religion

emphasis from Freud's impulse theory of neurosis to a
guilt theory. Actually, as is now evident, this position had
been anticipated by Runestam (1932), Boisen (1936),
and Stekel (1938), and it now seems to be steadily
gaining in acceptance. However, the doctrine of repres-
sion, upon which the difference in opinion here hinges,
is a subtle one and not easily amenable to objective
verification, so the issue has remained a debatable one
[see Chapter 2].

But there is another way of putting the problem which
makes it more immediately researchable. According to
Freud and his followers, the neurotic is in trouble, not
because of anything actually wrong which he has doney
but merely because of things he would like to do but,
quite unrealistically, is afraid to. By contrast, the other
view is that in neurosis (and functional psychosis), the
individual has committed tangible misdeeds, which have
remained unacknowledged and unredeemed and that his
anxieties thus have a realistic social basis and justification.

So conceived, the difference between the two positions
can be empirically studied with soirie precision. Accord-
ing to the Freudian view, the neurotic should have a
history of something like saintliness; whereas, according
to the other position, he should have a record (albeit
a carefully concealed one) of actual and incontestable
misconduct and perversity. This issue should by all means
be submitted to systematic investigation on a scale cor-
responding to its significance. But I confess that, for
myself, I am already pretty well persuaded what the
results would be and will here merely cite a few examples
of the kinds of evidence which is already widely available
on this score and which I, personally, find convincing.

In the summer of 1956, a manuscript was transmitted
to me which has now been published in the Journal of
Abnormal and Social Psychology (Anonymous, 1958),
for which I wrote the following brief introduction. The
paper, I should say, is entitled "A New Theory of Schizo-
phrenia."

This remarkable paper was written some two years ago
by a then 34-year-old man residing in a closed ward in one
of our large VA hospitals with a diagnosis of "paranoid
schizophrenia." Soon after the original manuscript came

I

Guilt, Confession, and Expiation 85

into my hands (through a former student), I had it mimeo-
graphed and, in the interim, as occasion arose, have obtained
reactions thereto from several chnical psychologists, psy-
chiatrists, and theologians. The evaluations fall into two
categories: some hold that the paper is just what it purports
to be, an original and highly reasonable theory of schizo-
phrenia — ^while others insist that it is a classical exhibit of the
disease itself.

The present judgment of the author, now no longer
hospitalized, is that his paper, as it stands, is probably valid
as far as it goes but needs to be elaborated and extended in
certain ways. It is hoped that his further thinking in this
connection can be separately published at a later date. In
the meantime, readers will be free to form their own opinions
as to whether the production presented herewith is an essen-
tially valid, albeit perhaps partial, theory of schizophrenia —
or just a "phenomenological perspective." . . .

Here it need only be added that the author of the follow-
ing essay has a history of personal waywardness and perver-
sion (hence the anonymity) which could easily support his
original thesis. He regards the present document as largely
an expression of unconscious processes, rather than as some-
thing that he carefully reasoned out. It was written, he says,
"while I was still following signals and colors; some of it was
almost automatic writing." The author gives additional infor-
mation about himself at the end of the paper.

Before proceeding with a synopsis of the paper proper,
it will be well to present the following information,
ivhich the author himself gives as his "qualifications" for
ivriting such a paper. He lists them thus:

Nearly four years of psychotherapy.

Nearly two years of living in mental hospitals.

Observation of my mother, who is now hospitalized for
the fourth time.

Twelve to fifteen years of self -analysis.

A B.A, degree and one year of graduate work in psy-
chology with philosophy as a minor.

99th percentile on the Graduate Record Examination in
psychology.

A nearly life-long desire to contribute to knowledge, espe-
cially to solve the problem of mental illness.

But now, to return to the essay itself. Near the outset
the author — whom we shall know as Tim Wilkins —
jays:

86 The Crisis in Psychiatry and Religion

I propose that the motive force of schizophrenic reactions
is fear, just as fear motivates, according to Freud, neurotic
mechanisms — but with this difference: in the case of schizo-,
phrenia, the chronic fear is more properly called terror, ot
concealed panic, being of the greatest intensity; and second!
as is not the case in neurosis, the fear is conscious; thirdJ*
the fear itself is concealed from other people, the motive of
the concealment being fear. In neurosis a sexual or hostile
drive, pointing to the future, is defended against. In schizo-
phrenia, by my view, detection by others of a guilty deed,
the detection pointing to the past, is defended against
(pp. 2-3).

One of the things that gives this document particular
authenticity, for me, is the way in which the author here
accepts, without question, the validity of Freud's theory
of neurosis but then goes on to report his own very
different inductions about schizophrenia. By 1946 or '47,
when Wilkins had his last contact with academic psy-
chology, the Freudian theory of neurosis was still very
much in vogue; and, writing in 1956, Wilkins seems to
have been quite unaware how widely that theory was
being replaced by an alternative view quite similar to his
own. The fact that Wilkins apparently did not know
of these developments, as far as the theory of neurosis
was concerned, therefore gives his formulations concern-
ing the schizophrenic psychoses special cogency and
independence — and constitutes, perhaps, still another
indication of the weakness of the classical Freudian posi-
tion.

But what, more specifically, is Wilkins' theory of
schizophrenia? As much as possible it will be presented
in Wilkins' own words.

My hypothesis [says Wilkins] may be called the Dick
Tracy theory loosely in honor of the familiar fictional,]
human bloodhound of crime. I

Motivated in the very first place by fear, the schizophrenic
psychoses originate in a break with sincerity, and not in the
classically assumed "break with reality." The patient's social
appetite (an instinctive drive in primates, I believe), includ-
ing love and respect for persons and society, is consciously
anticathected or forsaken and ultimately repressed with the
passage of time, since full satisfaction of sociality entails,
more or less, communicative honesty, faith, and intimacy.
Also, the tension set up in interpersonal intimacy by the

[^uiLT, Confession, and Expiation 87

withholding of emotionally important (although perhaps
logically irrelevant) information causes unbearable pain. This
repression of sociality accounts for the well-known "indif-
ference" of schizophrenics. But if safety can be achieved by
means of "perjury" alone without great discomfort, then
no further defenses are adopted. Perjury is here defined as
avoiding telling the whole truth and nothing but the truth.
If, for many possible reasons, perjury is not an adequate and
comfortable guarantee of safety, as it usually is not, then
"cutting" of social contacts is progressively pursued — all in
the interest of safety in respect to avoiding possible punish-
ment. Suppression and repression of the social appetite or
instinct is thus central to schizophrenia. I believe that repres-
sion of sexual and hostile drive is not primary in schizo-
phrenia, although it is secondary, as will be explained further
on.

Schizophrenia is the cultivation of a lie. A lie is "proved"
to be the "Truth." The real truth is that the schizophrenic
is responsibly guilty for some crucial misdeeds. . . .

In my view a large amount of the damage to the schizo-
phrenic's self-esteem results from his contemplation of his
own vicious insincerity — which damage is more an effect
than a cause of his disease. His unethical defense mechanisms
cause him deep shame and fear of loss of others' esteem.
In addition, the primary deeds — ^whose exposure and punish-
ment are avoided by the disease — are shameful. . . .

More broadly speaking, schizophrenia shares with all func-
tional mental illness the ultimate danger of punishment
meted out by men, demigods, or gods. Common punish-
ments feared are the being deprived of love of kith or kin,
loss of social status, financial security, etc., and especially
in the case of schizophrenia the more violent punishments
such as being abominated by kith or kin, bodily mutilation,
imprisonment, lynching, execution.

This abandonment of social ties and good feeling, in the
interest of personal safety, is sometimes starkly simple, as in
mutism, but is usually supplemented by the development of
"phony" social behavior, that is to say, designedly cryptic or
misleading expressions of interests, sentiments, opinions; de-
signedly unfriendly "friendliness;" asking only questions to
which the answers are already known; the limitation of
conduct to carefully self-criticized, self-rehearsed stratagems,
etc. The patient has aggressed, ultimately in self-defense, by
means of an undeclared, passive, preventive "war" against
his fellow men, and in the interest of preventing defeat
(positive victory is soon sensed to be hopeless of attainment)
most of his knowledge and sentiments, and indeed his spon-

88 The Crisis in Psychiatry and Religion

taneous behavioral tendencies, have been classified "top
secret." Whatever words he actually uses are employed, thus,
as self-defensive weapons. My Dick Tracy theory offers the
explanation that high reaction time results from "biding
time" in the service of caution.^ Time is needed in order to
creatively choose a "phony" (not spontaneous, not honest,
not satisfying — except with respect to fear) response that
will maximally conceal the patient's mental life and thus
insure safety.

A semi-instinctive deceptive stratagem leads schizophrenics,
like pursued rabbits, to "zigzag," thus baffling the pursuer's
expectations. Unpredictability is the stock-in-trade fetish of
schizophrenics. The proximate goal is to avoid being under-
stood. The ultimate goal is to avoid punishment. They "non-
want" punishment (pp. 227-228).

My hypothesis diverges from orthodox theory, I believe,
in insisting that a large part of the schizophrenic's fear is not
a symptom and is not repressed, but is the main pathogenic
force and is accessible to consciousness and even verbalization
were the psychotic to violate his more or less conscious policy
of dissembling.

There are understandable reasons why others may not have
developed this view sooner. The theorist is naturally made
to appear somewhat hard-hearted and accusatory [see Chap-
ter 21. The famihes and others related to the schizophrenic
would naturally resent the implication of crime. . . . [And]
it is easy to imagine and believe that physicians and psy-
chologists would not enjoy making a career of being acces-
sories after the fact or having their work open to such inter-
pretation in the sociological "climate" afforded by present-
day attitudes. Nor would professional healers in general
enjoy arranging for prosecution of patients.

In other words, this theory, even more so than Freud's
sexual emphasis, by its very nature would stand to be un-
popular aU around, both to the patients and the healers and
the social group which surrounds them both. In fact, were
it not that the truth promises to be practically invaluable
in the long run, I would hope that my theory is not true.

As Freud found Shakespeare's Hamlet to be representative
of neurosis, I take Shakespeare's Lady Macbeth to typify
schizophrenic psychoses. The motto of the schizophrenic
might well be, "Out, damned spot!" and that of the therapist
working with schizophrenics, "Find the crime!" (p. 228).

^The author is here alluding to a study of reaction time in
schizophrenics with which he was familiar.

Guilt, Confession, and Expiation 89

There then follow sections with these titles: "Schizo-
phrenia and Criminality Compared," "On Crime and
Punishment," "The Theory and Types of Schizophrenia,*'
and "Schizophrenia, A Social Disease," in which further
empirical evidence is mobilized in support of the theory
and implications drawn which might be tested by further
inquiry. And, toward the end of the section last cited,
ive find this wistful yet trenchant passage:

My theory makes schizophrenics out, in a sense, to be
villains. Yet obviously they would be bungling villains, and
the very botching of their lives strongly suggests forceful
extenuating circumstances, since without tremendous pressures
people seldom, presumptively, destroy what they love as
much as all people love themselves originally.

Irrelevantly, it is pleasant to say that human beings are
lent dignity (of a rather evil sort, if my theory is true) if one
credits the schizophrenics of the human race with being
real people who have fallen into disease by having failed to
make the right decisions at the right time in regard to
problems which even our philosophers and theologians have
not solved in the quiet of their studies with the help of
the written words of many other minds — while the schizo-
phrenics failed under enormous, frantic pressures, as is typ-
ically the case (p. 233).

Then there is a section entitled "Thoughts on Ther-
ipy" and, finally, a "Summary," which reads, in part,
IS follows:

So what is a schizophrenic? In brief, he is a terrified, con-
science-stricken crook, who has repressed his interest in
, people, unavowedly insincere and uncooperative, struggling
I against unconscious sexual perversion. He is of no mean
j Thespian ability. And his favorite Commandment is that
which one nowadays facetiously calls the Eleventh Com-
mandment, "Thou shalt not get caught."

Attempts to expose him may only drive him further
"underground." But a knowledge of his true nature will
surely lead, someday, to somebody's discovering a sure, quick,
effective and enduring cure (p. 236).

As already indicated, there are those who insist that
he sense of guilt and wrong-doing which the author of
his paper stresses is itself pathological; and some would
ven hold that the misdeeds to which the schizophrenic

90 The Crisis in Psychiatry and Religion

person points, if real, are an early expression of disease,
rather than a cause thereof. But this position has the
logical defect of making all misconduct interpretable in
this way and thus obliterates the whole concept of per-
sonal and moral responsibility. Moreover, there are now
psychiatrists, including some very eminent ones, whO;
feel that this view is unsound even when limited to the;
most obviously *'sick" individuals and that an entirely
different orientation is needed. For example, after the,
publication of Tim Wilkins' paper, Dr. Karl Menningei
(1958) wrote as follows:

I very much liked the article on schizophrenia ... in the
September issue of THE JOURNAL OF ABNORMAI
AND SOCIAL PSYCHOLOGY. I wish you would tell [the
author] that I think it is fine and that it would be even
little better, in my opinion, if he would not try to distinguis
between schizophrenia and other groups of symptoms. Essen
tially all mental illness must be a reaction to some kind o
feeling of rupture with the social environment, and of course
it is typical of many patients to identify this with their owi
aggressive intent or even aggressive acts for which, as [th<
author] says, they feel guilty and about which they ar«
defensive and evasive and insincere.

Or consider this observation, reported by Hock
Polatin (1949) in connection with their study of a larg
group of borderline — or what they prefer to call "pseudo
neurotic" — schizophrenics :

In all the writers' cases, they observed that the patien
usually told of a great many sexual preoccupations showin
autoerotic, oral, anal, homosexual and heterosexual tendencie:
and ideas which sometimes resembled a textbook of ps)
chopathia sexualis. These polymorphus perverse manifest
tions, this chaotic organization of the patient's sexuality, tb
writers feel, is rather characteristic of these schizophreni
cases. Marked sadistic or sado-masochistic behavior is ofte
linked with this sexual material. This is especially true i
patients who rather overtly and without restraint, expre:
incestuous ideas. Many of these patients, especially und(
sodium amytal, verbalize these ideas freely, or express thei
freely in drawings (p. 253).

Recently a state hospital conducted an all-day institui
for clergymen for which the head of the Social Servic
Department had prepared a case history of a 33-year-o]

Guilt, Confession, and Expiation 91

woman who, it was felt, rather well typified entering
patients. For a period of two years, this woman had been
having an affair with her brother-in-law; she had on one
occasion assaulted her husband with a butcher knife;
and on another occasion had thrown a small child over
a backyard fence. Finally she became suicidal and had
to be hospitalized.

And so might one continue, indefinitely, to mobilize
bvidence that sin and emotional sickness are no strangers
to one another and that it is only by flagrant disregard
oi the clinical facts that one can imagine that neurotic
and functionally psychotic individuals have been too
:horoughly socialized and are the victims of an unduly
evere, oppressive morality. Therefore, although it is
Realized that the evidence cited will probably not be
ufficient to convince anyone holding a strongly contrary
^^iew, it will be accepted here as typical of a much larger
body of facts which justify further consideration of the
dew that mental illness is a social and moral illness and,
in the final analysis, capable of remediation only along
social and moral lines.

[I. GUILT, REMORSE, AND CONFESSION

If it be true that emotionally ill persons are typically
guilty persons, i.e., persons with real guilt rather than
mere guilt feelings^ the question very naturally arises as
:o what can be done to alleviate such a state of affairs.
Everyone apparently has an intuitive compulsion to
idmit, or confess, his guilt to others; but this is a very
Dainful act and is likely to occur only under great
irgency. A dramatic itistance of confession, and the
conflict it involves, is given in the following paragraphs.
rhey are taken from Standal & Corsini's (1959) book,

ritical Incidents in Psychotherapy. I may say that
Jie counselor here reporting is not identified, and the
client is known only as ''Jo^'^-" The counselor begins by
^ving the background facts:

Joan is a nineteen year old college freshman. She was first
seen while she was attending Junior College. The school
psychologist had diagnosed her as a Paranoid Schizophrenic
on the basis of a Rorschach test and had referred her for

92 The Crisis in Psychiatry and Religion

psychotherapy to a counsehng center which uses a chent
centered approach.

The therapist to whom Joan was assigned (the preseni
author), noted no psychotic symptoms until the sixth inter
view when she had an hallucination and expressed some
bizarre ideas. After this interview, the therapist asked for £
consultation with a psychiatrist which was followed by a joini
interview with the patient and continuing consultation durin§
the course of treatment.

The critical incident described occurred in the fourteentl:
interview. Joan had been seen initially for eight interviews
followed by a month and a half of summer vacation, anc
then five more interviews before she left town to go to i
state university. She had been at the university for one weel
when she called the therapist and said she wanted to com(
back during the weekend for an appointment. One was sel
for five o'clock on Saturday.

Joan arrived almost on time, breaking a precedent oj
coming consistently twenty to thirty minutes late. She saic
she was quite disturbed and had tried to reach me twic{
during the afternoon but I wasn't there.

I asked her how much time she would like. (Our previou:
interviews had all been for whatever was left of fifty minute:
after her late arrival.) I opened the possibility of a longei
interview in reaction to her apparent degree of disturbance
and the inaccessibility of the clinic to her new residence aij
the university. She asked, "What do you mean?" I said, "Ij
wonder if you would like more than an hour today?" Sh(i
said, "Yeah, I would." I asked her, "Well, how much tim^i
would you like?" She did not try to answer the questioi!
so I said, "Suppose we continue until we both get hungrj
and it's time to go home for supper."

She began then talking about her experience at the univer
sity. She described the loneliness that she felt — the isolation
Nobody really loved her. She just felt all alone in the world
Life was so depressing that she couldn't work up interest ii
anything. She didn't have the push to do anything. If sh(
had the push, she thinks she would commit suicide. If th(
future were merely an extension of the present, then r
would not be worth living for. She was expressing a deej
despair when she began to pull herself together again. Theo
would be some hope if she could change herself. She begai
to feel that maybe she did have the possibility for changing

During a pause in this working through of feeling, '.
wondered about the time. Taking out my watch, I discov
fxed that it was six-thirty and that we had been togethe.
for an hour and a half. I put my watch on the desk anc
asked her, "How much more time do you want?" She didn'

!JuiLT, Confession, and Expiation 93

answer. The watch sounded loud ticking away, so I put it
back in my pocket. We went on until about seven, when I
, began to feel weak and wasn't following her very well. I
said this to her and she looked up at me like a scared rabbit.
She smiled in a forced way and began putting on her coat
j as if preparing to leave. I said, "You looked frightened when
I I suggested it might be time to stop." She nodded. I said,
! "Almost as if you thought I was rejecting you then." She
said, "Yes, that's what it looked like to me." Then she pulled
i her coat together over her chest. Her hands clenched strongly
on the coat and she started to stare at the wall. Her eyes
got red but no tears came. She began to tremble. I did not
understand what was happening and said, "It seems as if
the feelings you have now are making you afraid." She just
nodded without looking at me. Her trembling and staring
went on for about eight minutes. Then she stood up in
front of me. I asked her if she wanted to go home. She
looked at me, smiled again in a mechanical fashion and
shook her head "no." Then she began wringing her hands,
staring at the wall and shaking all over. From time to time
her body would lean toward me and then lean away. My
heart was beating like a trip hammer. I didn't understand
what was happening to her. I was afraid that she might be
going into a psychotic break. After about ten minutes of
throbbing silence, I said, "It's hard for me to understand
what you are feeling." Then she said that she was looking
at the lambs on the wall, the faces of the lambs. (There
was a flower print on the wall.) "They have two eyes. One
is a mean eye and the other is a kind eye. I see the faces of
my mother and my grandmother. They are telling me to
control myself and I hate them" (pp. 38-40).

When I have previously presented this material orally,
have usually stopped at this point and asked for the
ipressions of others as to what, precisely, was going on
2re. Even a group of laymen will come through with
fairly accurate appraisal. They will see, first of all, the
^inly veiled seductiveness of the client: her avowed
neliness and vagueness about when she needs to leave,
^hen the therapist tries to force the latter issue, Joan
oked frightened, hurt — and he interprets this, probably
lite correctly, as indicating a feeling on Joan's part of
?ing "rejected." Clearly the counselor had rejected Joan
regards any sexual advances that she may have been
aking to him. With the situation thus clarified and
estructured," things began to happen. Almost imme-

94 The Crisis in Psychiatry and Religion

diately, "she pulled her coat together over her chest. He
hands clenched strongly on the coat and she started t(
stare at the wall." Presently she stood up in front o
the therapist and physically acted-out her conflict b'
alternatively leaning toward and away from him. Thei
she hallucinated. Eyes are a proverbial symbol of author
ity and conscience, and Joan reflects her ambivaleno
toward them by seeing one of the eyes of each lamb*
face as good, one bad. Then Joan sees the faces of he
mother and grandmother — faces, so to say, which wer
''behind" conscience. *They are telling me to contro
myself and I hate them." The fact that moral authoriti
had here been internalized but not assimilated is thuj
apparent; and it is noteworthy that such authority ij
depicted as exclusively female — there is no fatherly fac
here.

Having thus paused the better to grasp this rapid
moving and dramatic scene, we now return to th
counselor's narrative.

I told her I was puzzled. Then I said, "I wonder if yo
are saying — in part you like yourself, in part you don't li
yourself." She said, "No. It's other people's reactions to mf
They partly like me and partly don't like me." She said thz
one of the eyes was covered over with wool. I said,
wonder if you are saying that if people really knew you-
could see the real you — that they would not like you." Sh
said, "Yes." '

In between these times when we talked together, she WJ
still standing, trembling, wringing her hands and staring
the wall. Then she began to tell me, in a very circuitoi
way, about her relationship with her father. She started oi
by saying that when she was thirteen years old, she ha
seen the divorce papers of her parents. In those papers
said that her father had not wanted her before she was bon
Then she went on to describe her father's attitude towai
her and after many hints told me about having had incestuoi
relations with her father. She described this as the experiem
which has made her dirty, no good, horrible.

She had been standing and shaking for half an hour bi
having brought out this report of incest, she sat down an

^No explicit reference is made here, by either the client i
the counselor, to the common expression, "pulling the wool
over another's eyes as a metaphor for deception; but it seen
to have been mutually understood and accepted.

^uiLT, Confession, and Expiation 95

relaxed. She looked at me while she talked, really seeing me
for the first time since she had stood up and described how
this experience had affected every part of her life. She had
never told this to anyone before. She felt she could not tell
her mother or her grandmother. Even with her father, she
pretends that it had never happened and he never mentions
it. She no longer has sex relations with him but when she
visits him (her parents are separated) she takes along a
friend to protect herself.

When it was about eight o'clock, I found I was again
beginning to get hungry. I said, "Well, I'm beginning to
get weak again." She said, "You know, I've got a headache
and I'm hungry. I'm just all worn out and I really haven't
much more to say today. But I couldn't tell you. I couldn't
suggest that we stop." It developed that she was afraid that
that would be rejecting me.

Again it takes no special intuitiveness to see what had
ccurred here. Joan had come to the interview conflicted
etween the possibility of admitting the incestuous rela-
onship with her father and of replicating it, with the
Dunselor. What she would have actually done had the
Dunselor gone along with the first possibility we can
nly conjecture — first of all because this is not what
appened and secondly because, if it had, there would
ave been no record of the case, or at least not one
3luntarily supplied by the counselor! But the mystery

still not completely solved. Why does Joan have to
ngle out this particular man? Surely there were both
lore appropriate and more accessible sex objects in even
er impoverished social environment than this obviously
:der, presumably married, and professionally responsible
[dividual. Actually, the very paradox provides the key.
)an arranged this Saturday-afternoon tryst with the
)unselor, not because she was sexually starved, but
2cause she was morally oppressed; and if she could
ave seduced this father figure, as she had her original,
.ological father, she would have won at least a transitory,
lOugh ultimately bogus, moral victory of considerable
iagnitude.3

'Only those without experience in the psychotherapeutic
:uation will regard the sexual interplay here implied as either
lusual or misperceived. The only question is one of interpreta-
)n, "dynamics," meaning.

96 The Crisis in Psychiatry and Religiq

Certainly it was no accident that her father's face wj
not among those staring out at Joan from the wall-
and from the past. As a father he was dead — and Joa
had helped kill him. Having with Joan's cooperatio
irreparably disgraced and disqualified himself for tk
role, he could no longer *'face" her. But the mothti
and the grandmother had not been so effectively dispose
of; and although Joan hated them, they gave her no res'
So on this fateful Saturday afternoon, Joan came nc
awooing in any usual sense of that term, but rather wit
confused and mixed intentions of confession and "mu:
der." But her possible victim was this time immune t
her devices. When confronted by a hardly mistakabl
sexual invitation, all he did was to talk about how wea
and hungry he was feeling! And he was right in perceiv
ing that Joan, or at least a part of her, did "feel rejected.
This time Joan had met her match; this father wa
incorruptible. And she had the courage and characte
to make the most of it: to him she then confessed. Sh
had "tried" him, and he had qualified for this differen
role.

There is only a little more to the counselor's account
He concludes by asking a series of questions:

What part did the handling of time play in this interview
Did the indecisiveness of the therapist lead to a seductiv
interplay which aroused transference reactions, helping t
precipitate the temporary psychotic break? If so, how shouL
this be evaluated therapeutically? Would a firm initia
definition of limits by the therapist have cut off the possi
bility of the intensive catharsis which occurred during th
last hour? j

The therapist interpreted the client's hallucinatory thought!
in terms of her attitudes toward her self and her relationship!
with other people. What would have been the effect oi
merely reflecting the ideas which she was verbalizing? Whai
would have been the effect of interpreting her behavior iij
terms of a transference neurosis? I

Although the counselor seems to have had a gooc!
intuitive grasp of the situation and handled it well, ht:
was so preoccupied, apparently, with questions of "techi
nique" that he was consciously blinded to the deepei!
significance of what really transpired. After Joan said,'

Guilt, Confession, and Expiation 97

"But I couldn't tell you [and] I couldn't suggest that
we stop/' his comment is: "It developed that she was
afraid that that would be rejecting me." Surely something
far more profound was going on here than any such
terminology would imply; and it is with precisely this
Something More that we are here mainly concerned.

[II. IS CONFESSION ENOUGH?
THE PROBLEM OF EXPIATION

Despite the Biblical exhortation that an honest con-
fession is good for the soul, there is reason to doubt that
its benefit is unconditional and necessarily enduring; and
one wonders how much, in the long run, was really
accomplished in the episode we have just reviewed.
Immediately thereafter Joan, to be sure, felt vastly re-
lieved; but was she ''cured"? What guarantee was there,
really, that her guilt would be generally assuaged — or,
indeed, that she would not again resort to the very
behavior which had already caused her so much inner
discomfort? The author of the Dick Tracy theory puts
the problem well by asking in a part of his paper not
previously quoted: What good does it do to confess your
past errors to someone who is going to be as secretive
about them as you have been? This, he goes on to say, is
not the way for a person to achieve social redefinition
of personality and true redemption. Just as the offense
has been against society — that is, against the laws of man
and God — so, one might argue, the confession and
Forgiveness (''acceptance") must be as broad as the sin
itself.

Another one of the "critical incidents" collected by
Standal and Corsini bears quite directly upon this ques-
l:ion. Here a married woman consults a psychiatrist with
pomplaints of depression and obsessive thoughts that she
alight injure her young daughter. After desultory talk
(during the course of several interviews) had revealed
[lothing but an exemplary life, the psychiatrist confronted
che patient, almost roughly, with the logical incongruity
oetween her symptoms and what she had told him about
lerself. With great effort, there was then admission of a
;urprising and particularly degrading perversion; but there

98 The Crisis in Psychiatry and Religion

was no dramatic therapeutic gain. In fact, the report ends
with a comment by the psychiatrist to the effect that the
patient is ''still in treatment."

One is therefore prompted to wonder what would hap-
pen, in situations of this kind, if the confession took a
more "public" form. Fortunately we have something of
an answer in a case which has been briefly reported by
Dr. Anton Boisen (1958). He says:

The patient in question was a man of thirty-eight years
who was brought to the hospital in a severely agitated con-
dition. He thought he had committed the unpardonable sin
and that something was going to happen to his wife and
children. He would not, therefore, let them out of his sight.
He thought a world war was impending and when asked
what part he was to have in this war, he replied, "A little
child shall lead them." Obviously, he was the little child.

The record of his life was that of a well-meaning, friendly,
likeable person who before his marriage, and even afterward,
had been sexually promiscuous. What troubled him most was
an affair with a woman some ten years older than himself,
clearly a mother substitute. There had been two abortions,
for which he was responsible. She had died of carcinoma.
He blamed himself for her death and the disturbance began;
shortly thereafter.

The first symptom was heavy drinking. This continued!
until he lost his job. Following this, he suffered a depression
and stopped drinking. Then he developed the idea that thej
Odd Fellows were out to get him because he had violated]
the oath he took when he joined them. For several monthsi
he was obsessed with ideas of persecution. He reached
the point where he went to the police with a request for a!
permit to carry a gun in order to protect himself from his|
enemies. He then became finally so disturbed that he con-j
fessed to his wife, telling her of his sexual transgressions. !

This confession she took in good spirit, but in spite of thai]
fact he became more and more agitated. The idea came
that something was going to happen to her and that he had
to carry the weight of the world on his small shoulders
Commitment then became necessary. In the hospital he
showed intense anxiety. He was sure of only one thing, that
things were not what they seemed. He was also deepl}
aroused religiously. It is not necessary for our purpose tc
recount his subsequent history beyond reporting that within
a couple of months he made an excellent recovery and now.;
after nearly thirty years, there has been no further trouble*

i

Guilt, Confession, and Expiation 99

He is at present a successful contractor and his family is
prosperous and happy.

After noting that this man*s guilt was real and grievous,
Boisen then asks:

Why now the increased agitation following the confession
to his wife? Such a question is in order. The answer is clear.
The emotional disturbance was not the result but the pre-
condition of the confession. In his normal state of mind
confession would have been impossible. But the profound
emotion forced the confession, just as nature's heahng power
produces a boil or an abscess and then lets the poison matter
out. In this case, as in others of the type, the disturbance
brought about a certain degree of socialization. It got rid
of pretense and hypocrisy and put the sufferer in position
to be accepted for what he really was. And if it took some
time for this powerful emotion to subside, that is hardly to
be wondered at" (pp. 5-6, italics added).

All this is eminently reasonable, but does it not over-
look another possibility? Voluntary confession of a legal
crime may soften the ensuing punishment, but it does
not abrogate it. So, may we not assume that confession
of an immorality likewise does not end the matter? In
Dr. Boisen's case I conjecture that the period of hos-
pitalization was dynamically necessitated by the confes-
sion. This man, probably with human beings generally
in like situations, felt that accounts could not be righted
until he had, as we often say, ''taken his medicine" and
paid for his past misdeeds. Can it be that we do not
properly perceive this function of the mental hospital and
I hospitalization?

i Does mere confession of a legal crime absolve one from
'all further responsibility or punishment? Suppose that
jlO years ago I committed a murder and was never
[caught or even suspected. But as time passes, my own
knowledge of the act becomes increasingly oppressive
and I finally go to the local police and say: "You remem-
ber a man by the name of Joe Smith who was mys-
iteriously murdered a few years ago. Well, I thought you
might just like to know that I killed him." What would
then happen? Would the police say, "How very inter-
esting! We often wondered what happened to that fel-

100 The Crisis in Psychiatry and Religion

low. Drop in again sometime." Obviously not! I would
be taken into custody, would have to stand trial, and, if
formally convicted, would be sentenced to what was
deemed appropriate punishment.

Now is the moral law less demanding than the civil
and criminal codes? Does conscience have less rectitude
than a court? Unless we can answer this question affirma-
tively, it follows that in the moral realm, no less than in
law, confession is not enough and must be accompanied
by restitution. This possibility has been generally neg-
lected in our time and may account for widespread con-
fusion and misdirected therapeutic and redemptive effort.
Psychologists and psychiatrists have stressed the impor-
tance of "insight" rather than personal guilt and repent-
ence; and even the church has preached what Dietrich
Bonhoeffer (1948) has called the doctrine of "cheap
grace," which he holds is no grace at all [see Chapter 11].

So can it be that, lacking formal (institutional) recog-
nition of the need for atonement following sin, modern
men and women commonly make use, unconsciously, of
the stigma, disgrace, and suffering connected with being
"crazy" and hospitalized? Dr. Boisen (1936) has referred
to the insane as the self-condemned; and to this we might
add that they are also the self -punished. Depression is
manifestly a form of self-inflicted suffering; and it has
often been suspected that the reason why electro-convul-
sive shock "treatment" may speed the recovery of de-
pressed persons is that it aids the work of expiation. Cer-
tainly it is not uninstructive that even untreated depres-
sion tends to "run its course," that the prospect of
recovery from any one "attack" is always good but that
recurrences are statistically likely (hence the diagnosis
of "cyclothymia"). Therefore, a depression looks very
much like an act of "serving time," comparable to what
happens in those other places of penance (or peniten-
tiaries) where legally convicted offenders are sent. In
both instances, when one has "paid his debt to society,"
he is again free (of prison in the one case, of depression
in the other); and the question of whether an individual
will have one or more later depressions or will be "cured"
depends (in much the same way as does the reformatory
action of prison) upon whether he has really "connected"
crime and punishment.

A

Guilt, Confession, and Expiation 101

But what of schizophrenia? Here the likehhood of
"spontaneous remission" (getting "out," being "free") is
not nearly so great; and many students of the problem
have been led to suspect a deeper malignancy here —
tainted heredity, disordered metabolism, or the like. Can
it be that Tim Wilkins is right, that schizophrenia is no
less a moral disorder than is depression but that in the
one case the individual is still running, hiding, denying,
whereas in the other the individual at least unconsciously
admits his wrong and accepts the justice of suffering?
In the Boisen case — which had such a favorable outcome
— we have an individual who showed an admixture of
depressive and schizoid reactions; and apparently much
depends, with respect to recovery, upon whether one or
the other gains the ascendancy. As Dr. Boisen has else-
where (1936) pointed out, those persons who react to
personality crisis by becoming resentful and bitter and
who blame others rather than themselves are well on the
way to a permanently paranoid adjustment, with a very
poor prognosis. But when the individual can blame him-
self and see his predicament as one for which he is largely
responsible and which he can do something toward
changing, the prospects of recovery — and personal trans-
formation — are much brighter [see Chapter 13].

Toward which of these courses is would-be therapeutic
endeavor usually directed? How often we have tried to
get the neurotic or psychotic (sinful?) individual to see
his difficulties as stemming from sources outside his own
ego or self — from a too strict superego, from unreason-
able, tyrannical parents, or from a "sick society"! And
how often we have perhaps thus unwittingly pushed the
individual in the very direction that leads to destruction
rather than salvation!

At mid-twentieth century, perhaps secular psycho-
therapy has already rediscovered one ancient religious
truth and is on the verge of discovering another. Perhaps
one of the reasons why classical psychoanalysis, with its
cardinal emphasis upon "free association," so often makes
a painful and productive start and then tails off into
years of dull and unprofitable talk is that it does not help
the analysand move from free association (confession)
on to atonement, except to the extent that the financial
sacrifice which analysis usually entails provides it in at

102 The Crisis in Psychiatry and Religion

least temporary or ''symptomatic" form. Perhaps the
next half century will be well spent if we do nothing
more than learn how, once again, to make use of mean-
ingful and effective restitution as a regular and expected
concomitant of confession (cf. the book of Leviticus in
the Old Testament). Perhaps there are both individually
and socially more constructive forms of self-punishment
and atonement than incarceration in a mental hospital.^

* Since the above was written, the author has learned of a
book now in preparation, under the editorship of Dr. Albert
Eglash, which will bear the title, Creative Restitution: Guidance
and Rehabilitation of Offenders. Although concerned mainly with
the reclamation of legally defined criminals, this book may have
important implications for the mentally ill as well — if they,
too, are "offenders." The fact that, in the case of criminals,
confession or at least "conviction" has already occurred might
seem to make the total task of rehabilitation easier here than
with the mentally ill; but, being scZf-condemned, the latter
may, for this reason, have potentialities which at least the
criminal psychopath is commonly supposed to lack. Also, as an
emendation to what has been said in this paper, it should be
added that there is no intimation here that the particular
"crimes" to which the mentally ill confess have necessarily
occurred. As Tim Wilkins observes (in a part of his paper
which is not reproduced here), a trivial or even nonexistent
act may be reported and stressed to "cover" the real misdeed
(cf. Stafford, 1950; Mowrer, 1953; Fliess, 1957). Some psy-
chiatrists are of the opinion that it is a mistake to encourage
(or even permit) a psychotic individual to talk about the evil
acts he has committed, on the assumption that even though
he may start with valid reports he will soon progress to imagi-
nary "crimes" and thus become increasingly delusional and dis-
oriented. Two considerations are pertinent here: (a) If a
therapist took the patient's first report of wrong-doing seriously
and immediately started thinking with the patient about a plan
of restitution (instead of dismissing it as unimportant), perhaps
the patient would not need to compound his real sins with
fabricated ones; and (b) if a patient starts with a fabrication,
might it not be profitable to suggest that he try to return to
a less dramatic but more tangible and real action that may
have generated guilt?

I

Psychotherapy and the Problem

of Values in Historical Perspective

or,

The Devil and Psychopathology*

I-

One of the reasons for caution in accepting the hy-
pothesis that mental illness has a moral basis is the
ubiquity of the contrary view, that it is indeed an illness
and unrelated to anything for which the individual so
afflicted might be held accountable. Either the illness in-
terpretation is essentially sound or else, if erroneous, it
must be examined and explained as one of those remark-
able anomalies of which the history of culture is not,
alas, without precedent. Here we extend the effort al-
ready begun, in Chapter 6, to plumb the historical depths
of the problem and in this way, hopefully, discover cir-
cumstances which will shed new and much-needed light
on certain present-day perplexities.

This inquiry also brings us back, once again, to the
question of the nature of The Unconscious; and on the
surmise that it is benevolent, rather than evil (as Freud-
ian theory would have it), the possibility opens up for a
new synthesis of depth psychology and religion: namely,
that The Unconscious, thus reconceived, is akin to what
has otherwise been known as The Holy Spirit. This per-
ception of the situation is congruent with and a develop-
ment of the general position adumbrated in Chapter 2.
Such a re-evaluation and re-interpretation of The Un-
conscious may go far, not only to achieve such a rap-
prochement, but also to dispell the pessimism and im-
potence which have long beset the whole domain of
psychopathology.

* Initially prepared for a symposium on "Psychotherapy and
Values" held at Ohio State University, May 28-29, 1959, this
paper was also presented at the University of Minnesota, April
16, under the auspices of the Department of Psychology, and
later served as the second of the 1960 Earl Lectures, on
"Psychoanalysis and the Judeo-Christian Ethic."

103

104 The Crisis in Psychiatry and Religion

In a related paper [Chapter 8] the writer has suggested
that we have seriously erred in interpreting guilt, clini-
cally, as mere gm\t feeling rather than as a reality-based
state stemming from palpable, incontestable misconduct.
In support of this view, a paper entitled *'A New Theory
of Schizophrenia" by an anonymous author (1958) is
cited in which the position is taken that schizophrenia is
typically a condition in which a person is driven by a sort
of progressive terror lest his sins find him out. Then, in
an account of a dramatic interview with a young woman
known as Joan (Standal & Corsini, 1959), we see how
great the pressure may be, in some schizoid individuals,
to disclose their misconduct and thus, hopefully, find
peace and reconciliation. But confession, as we know,
may bring transitory relief without, however, effecting
a permanent cure. This consideration is exemplified in a
case history recently published by Boisen (1958), in
which a man becomes emotionally disturbed and con-
fesses infidelity and other serious breaches of morality to
his wife; but, far from finding an honest confession good
for his soul, this man becomes even more disturbed and
has to be hospitalized. Boisen's interpretation of this
course of events goes as follows.

The emotional disturbance was not the result but the
precondition of the confession. In his normal state of mind
confession would have been impossible. But the profound
emotion forced the confession, just as nature's healing power
produces a boil or an abscess and then lets the poison matter
out. . . . And if it took some time for this powerful
emotion to subside, that is hardly to be wondered at
(pp. 5-6).

In other words, the view here set forth by Boisen is
that by the time an internal crisis reaches a point where
it is powerful enough to prompt a confession, it may have
gained so much momentum that it "carries" the person
past the functional objective, which is confession and the
attainment of openness. In the paper first cited, I have
suggested the alternative possibility that disturbance
often continues beyond the point of confession (and thus
makes confession seem useless and even harmful) for
the reason that confession is not, of itself, dynamically
sufficient and must, in many instances, be accompanied

i

Psychotherapy and the Problem of Values 105

by some form of atonement or expiation. Where this de-
mand is consciously recognized, the individual may make
a profound resolution or "vow" v^hich will alter the en-
tire course of his life and thus ''save" him; but where
the needs of the situation are not so well understood, it
is as if the unconscious forces drive the individual into
manifest insanity (and hospitalization — or worse) as the
punishment, suffering, and humiliaton he must endure
before he can again (if ever) comfortably face himself
md others.

If, in the neurotic or psychotic individual, guilt is real
rather than fancied, the whole logic and strategy of
secular psychotherapy has to be reconsidered. I say if the
^uilt is real. This is a question of fact which has been
mswered to my own satisfaction but is, of course, open
to further investigation by others. However, granting
that the psychoneurotic individual is responsibly guilty
md not just a victim of false scruples, an even more
3asic question arises as to why Western civilization ever
:ame to doubt or deny the relationship between guilt,
^eal guilt, and psychopathology. This question can, I
relieve, be answered only in the light of certain broad
listorical developments, which we shall explore in the
pages that follow.

[. THE REFORMATION AND THE RISE
OF SECULAR PSYCHOTHERAPY

Prior to the Protestant Reformation, no one (relatively
jpeaking) doubted the reality of guilt. It did not matter
ivhether you felt guilty or not; if you had acted in cer-
tain ways, done certain things, you took it for granted
that you must confess and obtain forgiveness. Otherwise,
i^our soul was in mortal danger.

Martin Luther and the other Reformers, of course,
changed all this. There had, it seems, been widespread
ibuses and corruption, of a kind not without historical
precedent. For some time prior to the Reformation, re-
demption from guilt required not only that the individual
:onfess and do ordinary penance but that, in addition, he
buy special "indulgences," for himself and also for others
3ear to him who might now or at some future time be
in Purgatory (Bainton, 1950). Here one can hardly

106 The Crisis in Psychiatry and Religion

escape being reminded of the scene in the Temple where
Christ scourged the moneychangers for their traffic in
forgiveness. This outburst, probably more than any other
single act or combination of acts in the life of Christ,
turned the entrenched forces of orthodox Judaism against
him and led to his execution. Only by the most improb-
able combination of circumstances did Luther survive
the fury which his criticisms and insubordination re-
leased; and if one holds that the revolution which fol-
lowed was less momentous than the Christian "reforma-
tion/' who can say what would have happened if Luther,
too, had been martyred?

As the Protestant Reformation became consolidated,
it was, of course, inevitable that sweeping changes would
be instigated with respect to confession and penance.
Milder changes were readily imaginable; but both prac-
tices were, in effect, abolished. Grace, it was argued, is
not dependent upon other men but comes from God
alone. Therefore, you were to take your case to God, in
prayer, and ask for his forgiveness directly, without
priestly intervention. This arrangement was regarded
as a great stroke of genius. And I can remember my own
father telling me, as a child, a ''joke" which went as
follows. For some time a small boy had been given a
dollar every month and told to go to the priest for con-
fession. Finally, the boy became curious and asked his
parents who confessed the priest. The answer was, the
Bishop. Who then, he asked, confessed the Bishop? The
Cardinal, came the reply. Who confessed the Cardinal?
The Pope. And who confessed the Pope? No one con-
fessed the Pope, the boy's parents told him; he took his
sins to God. To which the boy, with a flash of inspira-
tion, exclaimed: ''I think I'll do as the Pope does; I, too,
will take my sins directly to God and save my dollar!"

This new provision for a short-cut to God and absolu-
tion was supposedly a great innovation, liberation, and
triumph. But history may yet show that it was instead a
grim and costly error. There can surely be no denying
that, on the whole. Protestantism has handled the prob-
lem of guilt very badly. It has left its followers in a state
which perhaps made them "creative" and "ambitious"
in a feverish, unhealthy way; but it has also disposed us

Psychotherapy and the Problem of Values 107

to the mass neurosis and pervasive anxiety which are so
much a part of the modem scene.^

Gradually Protestantism is recognizing this ambiguity
in its doctrines and practices and is today in the process
Df reinstituting confession. If this assertion seems rash, I
ivould cite the development of ''confession to a Christian
brother," as advocated by Deitrich Bonhoeffer (1954),.
in his book. Life Together, and now practiced in the
Serman Lutheran Church. But, even more pertinently, I
ivould call attention to the pervasive recourse to "pastoral
counseling" in this and other countries, which, although
it has the trappings of secular psychotherapy, is surely
but a disguised return of the confessional (see especially
Meehl et al, 1958, pp. 68-69). [See also Chapters 11
and 12.]

However, since pastoral counseling has been so largely
inspired by and patterned upon secular psychotherapy, it
is not surprising that it, too, has important shortcomings.
Secular psychotherapy, we must remember, does not really
beheve in guilt, only guilt feelings (or a "guilt sense";
White, 1956); and the aim of the type of "confession""
which it encourages, i.e., free association, is "insight""
rather than repentance and restitution. Moreover, as
Bonhoeffer (1948) in his book. The Cost of Disciple-
shipy argues. Protestantism has itself really abandoned

^In a footnote Fromm (1955) says: "All figures show that
Protestant countries have a much higher suicide rate than
Catholic countries. This may be due to a number of factors
inherent in the difference between the Catholic and Protestant
religions, such as the greater influence which the Catholic re-
ligion has on the life of its adherents, the more adequate means
to deal with a sense of guilt employed by the Catholic Church,
etc. But it must also be taken into account that the Protestant
countries are the ones in which the capitalistic mode of pro-
duction is developed further, and has molded the character of
the population more completely than in the Catholic countries,,
so that the difference between Protestant and Catholic countries
is also largely the difference between various stages in the
development of modern Capitahsm" (p. 151). Therefore, the
little story related above is doubly illuminating: it shows not
only the reduced capacity of Protestantism for handling in-
dividual guilt but also its encouragement of thrift and material
prosperity.

108 The Crisis in Psychiatry and Religiok

the strategy of confession and atonement in favor oi

what he calls the doctrine of "cheap grace."

I

Cheap grace is the preaching of forgiveness without re*
quiring repentance, baptism without Church discipline, Com^
munion without confession, absolution without contrition.
Cheap grace is grace without discipleship, grace without the
Cross, grace without Jesus Christ, living and incarnate. . .

Costly grace is the gospel which must be sought agaiiJ
and again, the gift which must be asked for, the door aH
which a man must knock. \

Such grace is costly because it calls us to follow, anq
it is grace because it calls us to follow Jesus Christ. It
is costly because it costs a man his life; and it is graai
because it gives a man the only true life. It is costly be
cause it condemns sin, and grace because it justifies the sinne;
(pp. 38-39).

Most pastoral counseling, as we know it today, there
fore falls short, as does secular psychotherapy, of th(;
crucial and ultimate step in the quest for salvation anc
personal wholeness. If one takes the neurotic's guilt se
riously, that is, if (as now seems likely) "neurosis" h
just a medical euphemism for a "state of sin" and socia
alienation, therapy must obviously go beyond men;
"counseling," to self-disclosure, not just to a therapist oi
counselor, but to the "significant others" in one's life
and then on to active redemption in the sense of th<
patient's making every effort within his power to undc
the evil for which he has previously been responsible. ^

^The Catholic Church has, of course, always taken guili
seriously to the extent of holding to the necessity of con
trition, confession, and satisfaction or penance {Catholu
Almanac, 1959 p. 277). And so the question is sometime;
asked. Why are Catholics not more protected than they arf
from personality disturbance, if the management of guilt anc
mental health are related? The answer seems to be: (a)
many Catholics do indeed enjoy unusually good mental health
(b) some Catholics — and indeed their confessors — are per
functory about confession and penance, i.e., the punishmeni
often does not fit the crime, psychologically; and (c) the Cath
olic Church identifies contrition, confession, and penance as i
sacrament, whose central aim is other-worldly salvation rathe
than mental health or adjustment in this life. Therefore, Cathol
icism provides no clear test, either in practice or in theory, o
what confession and penance can do in a more naturalistic way

Psychotherapy and the Problem of Values 109

At this juncture it is, of course, easy to get involved
in a tedious theological debate as to whether salvation
is by "good works" or by "grace alone." For myself, I
have no desire to argue the point but will merely state
that I, personally, take my stand with the Apostle James
and Deitrich Bonhoeffer, against the Apostle Paul and
Martin Luther, or at least against the extreme interpreta-
tions sometimes put upon their teachings. Be it granted
that it ill becomes a man to proclaim his own righteous-
aess — this, surely, is a judgment for others to render. But
to assume that grace or redemption or change comes only
as a result of divine election or selection is, to my way of
thinking, to cast a hopeless blight on the whole problem
[see Chapter 11; also Mowrer, 1961].

No other therapeutic or "redemptive" movement,
within the church or without, has in recent times been so
successful as Alcoholics Anonymous. Here guilt is seen as
basic and real; and its open admission is regarded as an
indispensable first step, to be followed by a definite
program of good works and restitution. Sometimes, when
the accomplishments of Alcoholics Anonymous are al-
luded to, it is asked: But why was the Oxford Group not
also a success? Up to a point the Oxford Group was a
success (see Glark, 1951); and that point was that it
encouraged confession and openness but had no provi-
sion for taking its members on from there. If it did noth-
ing more, the movement deserves credit for having in-
spired the formation of AA, where the weakness of pure
Buchmanism is offset by a clearly specified program of
"missions" and mercy.

The trial which AA has blazed is the only one down
iwhich I can at present gaze and see anything that looks
'like the road to the future. How AA principles can be
jadapted or modified to meet the needs of other kinds of
|:;onfused and suffering people is not fully clear to me.
IBut I am as sure as I can be of anything that no therapy
[will be radically and broadly successful which does not
itake the neurotic's guilt seriously and does not help him

For a quite remarkable, and unusual, attempt to deal with the
laturalistic (psychological) implications of confession in the
"Catholic context, see Wilson (1954) [see also Chapters 11

id 12].

110 The Crisis in Psychiatry and Religion

admit his errors openly and find ways to work in dead
earnest to rectify and compensate for them.

As an active churchman, I beheve that the concept o£
God is vital and meaningful and that the so-called 'Verti-
cal dimension/' between God and man, is vital and mean-
ingful; but I do not believe that this relationship can be
either vital or meaningful if it is not complemented and,
indeed, often preceded by serious concern on the part of
the individual with the horizontal dimension, namely,
the relation of man to man. The total situation has welli
been termed ''triangular," with God, the individual, and
one's fellowmen at the three corners. The nature of the
relationship is also well described by the following lines:

I sought my soul and sought My God,
But neither could I see;
And then I sought my neighbor,
And then I found all three.

Intrepid and bold as the Protestant Reformation un-
doubtedly was in many ways, one can hardly avoid the
judgment, at this vantage point in history, that it was
also crucially incomplete (cf. Section VI; also Tillich,
1948). If, for the third time in the past two thousand
years, there is again widespread mercenary traffic in for-
giveness, perhaps this scandal, no less than the former
ones, will prompt changes of a radical and "redemp-
tive" kind.

II. THE HISTORICAL SITUATION
AND FREUDIAN PSYCHOANALYSIS

In his Autobiography, Freud (1935) — writing with his
usual plausibility and charm — speaks of the circum-
stances, both personal and cultural, which prompted the
development of that remarkable body of theory and prac-
tice which was to be known as psychoanalysis. By the
end of the 19th Century, the church, as we have seen,
had largely abandoned its interest and claim to com-
petence in the area of psychopathology; and medicine
had an essentially organic conception of the problem,
with the result that there were, as Freud observed
"crowds of neurotics, whose numbers seemed further mul-
tiplied by the manner in which they hurried, with their

Psychotherapy and the Problem of Values 111

troubles unsolved, from one physician to another" (p.

27).

Being a Jew in a nominally Christian country, Freud
experienced one disappointment and frustration after an-
other in his original hope of securing an academic posi-
tion; and finding himself thus, as he said, ''forced into
the Opposition" (p. 24), the outcast Jewish doctor
eventually began, understandably enough, to direct his
professional attention to what we may also call the "out-
casts" among patients. The superabundance of neurotic
individuals who were seeking Something and not finding
it and the accident of Freud's finding himself now aligned
with "the Opposition" provided the sour soil in which
psychoanalysis germinated and began its growth. "My
therapeutic arsenal [in the beginning]," Freud said, "con-
tained only two weapons, electrotherapy and hypnotism,
for prescribing a visit to a hydropathic establishment
after a single consultation was an inadequate source of
income" (p. 25). And when, at length, Freud became
disgusted with both electrotherapy and hypnotism, he
simply began listening to his patient talk. From this
seemingly inauspicious beginning came the now well-
known analytic technique.

As we shall presently see, the solution which Freud
ultimately offered to the emotionally, morally, and
spiritually troubled person is very far from a religious
solution; and we are now beginning to supect that it is
also very far from a soundly scientific one. Yet the fact is
that Freud, and the disciples whom he soon attracted, at
least walked in the Valley of the Shadow with these un-
I happy, distraught individuals, in a way which neither the
ordinary physician nor the typical clergyman of the time
had been willing to do. Surely it is not without deep
significance that a theologian recently remarked: "Re-
gardless of whether Freud was right or wrong in his
theory, he at least tried to minister to a class of sufferers
ion whom the church, Protestant and Catholic alike, had
I turned its back. This is to our inescapable and enduring
ishame!" (De Wire, 1958).

The end of the 19th Century found the Catholic

Church still licking its wounds from the Reformation

\ and smarting from the memory of its folly in dealing with

Galileo. And, in the decades just past, the credibility of

112 The Crisis in Psychiatry and Religion

the Church had, of course, been further challenged by
Darwinian evolution. While Protestantism had perhaps
not shown the same degree of opposition to science, it
too was in a precarious state because, among other rea-j
sons, of its ineffective handling of the problem of guilt. !
Therefore, when Freud, in the name of science, began!
to proclaim discoveries in the realm of mind as revolu-!
tionary as those of Copernicus and Calileo in astronomy \
and of Darwin in biology, there was little religious vitality
to oppose him.

Although Freud thus spoke in the name of Science,
and eschewed all theological considerations, it is no ac-
cident that he was a Jew and that psychoanalysis, as'
ideology and as therapy, developed as it did. Having
suffered repeated rebuffs and disappointments at the
hands of what he referred to as the ''compact majority,"
Freud had no reason to be anything but gratified by the
embarrassment and failures of organized religion; and he
let no opportunity pass for striking at what was not only
a personal affront but also, as he conceived it, the enemy
of all mankind (cf. Freud, 1928). Having been excluded,
or at least so he imagined, from the opportunities and
privileges which would have perhaps been open to him
as a Christian, he gave up trying to function within con-
ventional boundaries and developed what he himself,
with magnificent understatement, termed "a certain de-
gree of independence of judgment" (p. 11).

III. FREUD AND THE KABBALISTIC TRADITION

Just how great was Freud's disaffection from conven-
tional streams of thought and values becomes clear when
we discover that not only was he alienated with respect
to Christianity but also from the main currents of
Judaism. In a remarkable book by David Bakan (1958a)
which will be considered more fully in the next section,
we learn that Freud's family, together with many other
Viennese Jews, had migrated from Galicia, which, says
Bakan, "had been saturated with Jewish mysticism" (p.
80), of the Kabbalistic variety. This sect, or splinter
group, differed from traditional rabbinical Judaism in a
number of ways which, as Bakan ingeniously shows,
strikingly anticipate important and distinguishing features

Psychotherapy and the Problem of Values 113

of psychoanalysis. The following excerpts capture some
of the salient features of Kabbala and suggest a probably
more than coincidental relationship to psychoanalysis.

One of the meanings of the word Kabbala is tradition in
. a way which connotes oral transmission. Another meaning is
acceptance as the mystics are accepted before God. A third
meaning of the term is that which is received, suggesting its
revelatory character. The Kabbala is something referred to
as the Secret Wisdom to indicate that it is comprehensible
only to the initiated. . . .

Kabbala has always had about it an aura of danger,
perhaps for good reason. In the light of the later psycho-
analytic developments, this danger may be best understood
as that associated with bringing repressed material into con-
sciousness (p. 70).

Recalling our earlier discussion of the friendship between
Freud and Fliess, Kabbalistic tradition provides a further
hint concerning the nature of the relationship. In his psycho-
analytic work, which we maintain is Kabbalistic, Freud
needed an "associate," because the burden of the Kab-
balistic thought is too difficult for anyone to bear in inde-
pendent study. . . .

The tradition is one pervaded by a sense of secrecy. . . .
The Kabbalists were endowed with mystery and power
(p. 71).

As will become increasingly evident in what follows, a
theory of repression and the role of the ego in repression
are already germinal here. Abulafia [a 13th-Century Spanish
Kabbalist] has essentially two methods of meditation in order
to achieve the desired release of the soul. The first of these
is an interpretative method based on taking liberties with
the letters of the alphabet (p. 76).

The second important method for which the first is but
a preparation is called "jumping and skipping" [which Bakan
identifies as a forerunner of the method of free association]
(p. 77).

Associated with such meditation is an intellectual ecstasy
identifiable with psychoanalytic insight (p. 79).

Furthermore, Abulafia regards the Kabbalistic teacher as
extremely important, a harbinger of the idea of the trans-
ference (p. 80).

That Freud would have had contact with Kabbalistic
thought and practice is insured by the circumstances al-
ready cited, to which can also be added the fact that dur-

114 The Crisis in Psychiatry and Religion

ing the latter half of the 19th Century Adolf Jellinek,
who was a close student of Kabbala, was, Bakan reports,
"the most popular Jewish preacher in the city of Vienna
in his day. It is said that when Jellinek spoke on the week
end the Jews of Vienna would discuss what he said for
the whole succeeding week" (p. 81).

Hence we arrive at the conclusion that Freud not only
stood apart from Christianity but that he had little af-
finity even for orthodox Judaism. He was, however, very
probably influenced, consciously or unconsciously, by a
singular and indeed somewhat sinister variety of Jewish
mysticism. In his expressed allegiance to science and in
yet other ways, Freud revealed also a sympathy with and
admiration for classical Greek culture, a fact which is
well known. But the knowledge of his affiliation with
Kabbalism, as brought out by Bakan, is new and puts
psychoanalysis into a surprising context, which will be
further considered in the next section.

IV. did FREUD ''play THE DEVIl"?

It is remarkable how slow we sometimes are to perceive
realities which we do not expect, or wish, to be true. It |
is more than thirty years now since the writer first he-\
came interested in psychoanalysis and resorted to it, as a i
form of psychotherapy and, hopefully, also as a new way
of life. For the better part of two decades he tried to
make it ''work" but to no avail; and so, little by little,
he became critical of psychoanalysis and returned to
more conventional views and values. And this experience
is today by no means uncommon. Yet it is with a real
sense of surprise and even shock that one reads the evi-
dence which Bakan, in his book Freud and the Jewish
Mystical Tradition (1958a), has assembled for believing
that Freud not only repudiated Mosaic and Christian
conceptions of God but, in addition, identified himself
with the Devil.

That Freud, as Bakan maintains, felt himself in mortal
conflict with Moses, the Law Giver, is not, of itself, sur-
prising. Perhaps the most basic tenet of psychoanalysis is
that neurosis is due to too great severity of the superego;
and Freud may be said to have "invented" psychoanalysis .
for the avowed purpose of combatting conscience, the

Psychotherapy and the Problem of Values 115

superego, the Law, and, by implication, the Law Giver.
Then, reasons Bakan (1958b):

If Freud conceives of himself as the new Lawgiver, . . .
he must at one and the same time be like unto Moses, the
previous Lawgiver, whose place he must preempt, and must
be destructive of Moses. The new Lawgiver must revoke
the older Law. The identification with Moses turns into its
opposite, the destruction of Moses" (pp. 323-24).

The Talmud and the other Rabbinical writings constitute
an elaboration of dicta of the Mosaic code, which the Ortho-
dox Jew takes upon himself to guide his life at every moment
and in connection with every action. In a word, Moses is
representative of the superego, the force generated within
the individual to keep him from "instinctual gratification."
The force which maintains renunciation of instinctual gratifi-
cation is the fear of punishment. In the allegory of the
discussion of a statue [of Moses, by Michelangelo] Freud
is saying that the feared punishment will never eventuate.
The superego is restrained (p. 324).

Freud's repeated affirmation of his Jewish identity becomes
illuminated through Moses and Monotheism. If it is the
Jew who carries the burden of the historical superego, then
it is only a Jew who can really remove the sense of sin. We
recall in this connection Freud's assertion that psycho-
analysis could only have been created by a Jew; in a letter
to his Swiss friend Oskar Pfister he wrote, ". . . by the
way, how comes it that none of the godly ever devised
psychoanalysis and that one had to wait for a godless Jew?"
If the Jews represent the authority of the Law, only a Jew
can declare that the Law is dead. Psychoanalysis, in this
larger cultural sense, may be viewed as a fundamental effort
to modify the classical image of the Jew. . . . Thus Freud
plays the role of a new Moses who comes down with a new
Law dedicated to personal psychological liberty (p. 329).

For Freud and psychoanalysis the task of treating
neurotic individuals thus became at one with the libera-
tion of mankind from the Mosaic Law, a task which
pakan (1958a) characterizes as ''Messianic." He says:

One of the critical features of Messianism is its goal of
leading people out of slavery and oppression. Thus Freud's
whole effort at the creation of psychoanalysis may be viewed
as Messianic in this respect (p. 170).

But since the oppressor was none other than the
mighty Moses and since his traditional adversary was the

116 The Crisis in Psychiatry and Religion

Devil himself, it is logical — though none the less astonish-
ing — that Freud should have consciously identified him-
self with the Devil. At the end of Chapter 22 Bakan i
quotes Freud as having once remarked to colleagues:

Do you not know that I am the Devil? All my life I have
had to play the Devil, in order that others would be able to
build the most beautiful cathedrals with the materials that
I produced (p. 181).

There then follow the five chapters which comprise
Part IV of the Bakan book, entitled 'The Devil as Sus-
pended Superego." In 1923 Freud published a remark-
able paper on "A Neurosis of Demoniacal Possession in
the Seventeenth Century," in which he relates the story
of the painter Christoph Haitzmann, who in a period of
discouragement and depression had contracted with the
Devil to be his, body and soul, at the end of nine years
in return for success in his art and surcease from sadness.
As the time approached for the contract to be consum-
mated, Haitzmann became increasingly agitated (show-
ing symptoms which would today probably be regarded
as schizophrenic — see Macalpine & Hunter, 1956) and
successfully sought priestly intervention and protection.

In Freud and the Jewish Mystical Tradition, Bakan
develops and convincingly documents the thesis that, at
least metaphorically, Freud himself had, some twenty-
five years earlier, entered into a "Satanic Pact" and that
psychoanalysis was the result thereof. For a period prior
to the publication of Die Traumbeutiing in 1900 (which
he always regarded as his masterpiece), Freud had been
in a state of unproductivity, discouragement, and depres-
sion (as is now known from the Fliess correspondence;
see Bakan, 1958a, p. 221 and p. 224). But then some
sort of personal change or rearrangement of his emotions
and mental powers took place; and we get more than a
hint of what this change was from the motto in Latin
which appears on the title page of this book. The quota-
tion is taken from a passage of Virgil's Aeneid and, when
translated in its entirety, reads:

Well, if my powers are not great enough, I shall not
hesitate — that is sure — to ask help wherever help may be
found. If the gods above are no use to me, then I'll move
all hell. I

Psychotherapy and the Problem of Values 117
And here Bakan comments, insightfully:

If God is identified with the superego, then the corre-
sponding antagonistic image is the Devil, who dwells iii
hell. As we have indicated earlier, in the psychoanalytic
relationship the analyst is at one and the same time the
representative of the superego as well as a tolerant, under-
standing father figure. Now what is the Devil, psychologi-
cally? The answer is eminently simple, on one level. The
Devil is the suspended superego. He is the permissive super-
ego. The Devil is that part of the person which permits him
to violate the precepts of the superego (p. 211).

In summarizing Chapter 27, Bakan says:

In our discussion of hypnosis, cocaine, and the transference,
indications of suspension of the superego were suggested.
Our introduction of the Devil idea into this discussion rounds
out the great drama which was taking place in Freud's mind
in his creation of psychoanalysis . . . (pp. 212-213).

And finally, toward the end of Chapter 30, we read:

The Devil is then a cure for despair. He is called upon
as an assertive act when all hope is gone. And in this sense
also, the Devil is always the Tempter. The essential message
of the Tempter is that the anticipated rewards associated
i with resistance to temptation will not be forthcoming, that
j faith is groundless. The Devil presents the new hope, and
supports this promise by immediate tokens of his favor.
But since these tokens themselves bring so much relief, one
permits oneself, in his relationship to the Devil, to be thus
taken in (by the Devil), since he feels that he has already
been taken in (by God).

In more secular terms, Freud suffered from acute depres-
sions. His self-analysis, and his development of psychoanalysis,
were the cure for his depression. His practice had already
provided him with ample evidence that diseases which other
people were suffering from, for which there was no other
hope, could be cured by such means. In his despair over
making a living, and in his despair over anti-Semitism, he
had 'little or nothing to lose" by his "audacity." Further-
more, this new set of methods which he was producing held
out the promise of bringing patients to him and so solving
at least the problem of making a living (p. 236).

Thus does Bakan develop and document his conten-
tion that Freud, at least metaphorically, "played the
Devil" — ^but that he did so in a good cause. However, as

118 The Crisis in Psychiatry and Religion

we know, "playing the Devil" also carries the implication
of eventually causing disaster! It is this aspect of the
situation to which we now turn our attention.

V. THE ROLE OF THE PSYCHOANALYST

THERAPIST OR TEMPTER?

Today no one, of course, "believes" in the Devil in
the sense in which he was conceived in the Middle Ages.
Instead, we have come to "believe" in Freud and psy-
choanalysis. But now we are confronted by the astonish-
ing possibility that Freud and his works are the 20th-
century equivalent of the Devil, thinly disguised. And
this possibility is rendered all the more palpable by the
fact that Bakan, who has so vividly brought this pos-
sibility to our attention, is himself an admirer and de-
fender of Freud. The logic by which Bakan reconciles
this apparent contradiction and justifies his "audacity"
cannot be reproduced here, partly because it is intricate
and partly because I am not sure I fully understand it.
But we can and should note one or two additional bits
of evidence which Bakan (1958a) adduces in support of
his remarkable thesis:

The question of the seriousness of Freud's entry into the
Satanic Pact may well be raised. Freud was a modern man
who did not believe in supernatural beings (p. 215).

Perhaps precisely because Freud did not accept the super-
natural reality of the Devil, he could permit himself the
full exploitation of the metaphor. We may imagine that
at times the sense of possession became quite strong; and
it is this feeling of possession that Freud is analyzing in his
paper [ostensibly dealing with the 17th-Century painter,
Christoph Haitzmann] (219).

"According to Bakan, both Freud and Haitzmann had
sought the help of the Devil in their struggle against
depression, which is a work of the superego. Therefore,
metaphorically at least, the powers of the Devil might
be thought of as generally useful in the campaign against
the superego, a campaign which is supposed by psycho-
analysis to be so essential to the treatment of all neurosis.
Says Bakan:

Throughout the Middle Ages the Devil was a star in the
great spiritual drama which was then taking place. As Freud

'SYCHOTHERAPY AND THE PROBLEM OF VaLUES 119

had so aptly pointed out, even though the Devil is perhaps
no longer a personage in the same sense as in the Middle
Ages, the psychological phenomena associated with his image
are still current and important. We have already indicated
the psychological significance of the Devil image as an ally
against the superego, or better, as its suspension (p. 231).

More prosaically this can be stated as follows: The disease
of the neurotic is his guilt. This guilt is, in itself, an evil
and its removal is good. ... If God is the guilt-producing
image, then the Devil is the counterforce. . . .

As Freud said in discussing Anatole France's Revolt of
the Angels, "War will produce war and victory defeat. God
defeated becomes Satan and Satan victorious will become
God" (p. 233).

But enough of conjecture and finely spun inferences!
Vhat, in actual practice, is the strategy and goal of psy-
hoanalysis? Analysts have been a little hesitant about
mblishing verbatim accounts of what, in fact, transpires
n analysis. And when, on occasion, this reluctance has
)een overcome and verbatim transcripts have appeared,
me understands why analysis, like a Witches' Sabbath,
)rospers best in an atmosphere of secrecy and darkness.
7he following excerpts, quoted by de Grazia (1952)
rom a psychoanalytic transcription, illustrate the point:

patient: Not only is there this fear of being in an intimate
relationship with a woman, but I am also obsessed with the
fear concerning that blasphemous thought. The reason for
this seems to be that I had sold myself to the devil, merely
by thinking this thought to myself. It is a fear of being
possessed by the devil. I know it is rather absurd and based
on the ol<3 theology. The devil seems to represent all that is
evil or bad.

The fear of selling myself to the devil takes my thoughts
back to a dream I had at the age of 5 or 6 years. I was
sleeping with my mother at the time. I woke up trembling
very violently. I thought I saw a phantom fly across the
room. It was like a flame, and yet it was like an imp grinning
i at me. It flew across the room and out of the window. I was
scared to death.

therapist: What is the flame you would get if you were
sleeping with your mother?

patient: Love of my mother, I suppose.

therapist: What is the flame you would get if you were
sleeping with a young lady?

patient: Passion^

120 The Crisis in Psychiatry and Religion

therapist: Would you?

patient: No, I expect I should be scared to death, and
trembling violently, like I was in the dream.

. . . Now my main concern is this idea or obsession that
I am possessed by the devil.

therapist: Suppose you are?

patient: That would mean that one would lose control
of one's will.

therapist: What is natural?

patient: Do you mean that what I am afraid of is my
own natural urge to live a normal natural life . . . ?

And during the next session:

patient: Perhaps I am scared of a girl because I am
terrified that my sexual feelings might run away with me,
and I might not act rationally.

therapist: What might you do?

patient: I might love her too much.

therapist: What would that lead to?

patient: My desire would be to put my arms around her,
and tell her I love her. But I was scared.

therapist: Does that seem so terrifying?

patient: Well, I might have sexual intercourse with her:
that would be going too far.

therapist: Would it?

patient: Well, perhaps not as far as sexual intercourse.
If that is the devil, perhaps he is quite a harmless devil.
Perhaps the sooner I went to the devil the better.

therapist: If that is all there is to it, why is there all
this scare?

patient: Apparently all this time I have been afraid of
being possessed by my own nature. The thing I want more
than anything else is to lead a normal natural life. Since
coming to you I have understood that this fear of being
sold to the devil is nothing more or less than fear of my
own nature on the one hand, and on the other hand a
preference for it, which I have thought was a preference for
the devil.

The whole amazing thing has become quite plain to me.
It is amazing how the obsession left me last night after that
talk with you (pp. 100-102) [cf. Berg, 1948, pp. 78-80].

A playwrite could not have produced a better script
for a modern re-enactment of the temptation and fall of
man as it supposedly occurred in the Garden of Eden.
Here Adam and Eve were attracted by the possibility of

Psychotherapy and the Problem of Values 121

sating of the fruit of the Tree of Knowledge but were
restrained by God's contrary commandment (superego).
But, step by step, the Devil showed them how pleasant,
natural, and harmless eating the fruit would be. The
Devil succeeded, and Adam and Eve were "cured" of
their apple-eating inhibition. But the cure ultimately
proved, of course, to be worse than the "disease"; and
this seems also to hold for the fruits of psychoanalvsis.
[n one of the last papers he ever wrote, Freud (1937)
looked back upon the therapeutic accomplishments of
psychoanalysis and did not find them reassuring. Typi-
cally, Freud said, patients give the appearance of making
a good recovery and leave analysis; but then, sooner or
later, they are likely to experience a recurrence of their
old difficulties or the outbreak of new ones.

In studying various developments and changes we focus
our attention entirely on the result and we readily overlook
the fact that such processes are usually more or less incom-
plete, that is to say, the changes that take place are really
only partial. A shrewd satirist of the old Austria, Johann
Nestroy,. once said: "Every advance is only half as great as
it looks at first." One is tempted to think that this malicious
dictum is universally valid (p. 330).

J And two decades later, an eminent American analyst
;(Kubie, 1956) was prompted to confess:

In this connection I recall Edward Glover's statement
[personal communication] that analysts sometimes seem to
achieve their greatest successes when they are beginners. Even
if Glover's statement was in part an ironic and rueful jest,
it indicates a mood of healthy reserve about our right to
claim therapeutic omnipotence or omniscience. . . . My own
observations of analytic defeats have convinced me that
basic gaps remain in our knowledge of the dynamic processes
both of illness and of therapy. . . .

Only a few years ago (although it seems a long time in
my life as an analyst) I harbored the comforting expectation
that increasing analytic sophistication and experience would
yield a higher percentage of therapeutic successes. . . . My
reluctant impression is that this hope has not been realized
(p. 87).

From testimony now available from both the friends
ind the foes of analysis, it is clear that, at best, analysis
iasts a spell but does not cure. By aligning himself with

122 The Crisis in Psychiatry and Religion

the patient's id, the analyst ( "Devil"? ) may indeed suc-
ceed, as Bakan puts it, in suspending the superego; but
the superego (or conscience), more commonly than we
might wish to believe, is a reflection of enduring social
realities; and the advantage we gain by overcoming it in
analysis is dearly paid for later, many times over. Man's
salvation must surely come, not from his looking and
moving downward, but from an upward reach, toward
reconciliation and community, made by means of confes-
sion and manifest restitution.

VI. THE END OF AN ERA — ^AND AN ALTERNATIVE

Even though Freud today stands indicted of having
"played the Devil," there are many modern-minded men
and women who will not greatly blame him. By theii
narrowness, bigotry, arrogance, sanctimony, false piety,
irrealism, supernaturalism, and hypocrisy, several genera-
tions of theologians and laymen have given organized'
religion an exceedingly negative imprint and reputation;!
and if there have been those who said, "Let the Devilj
take them," it can hardly be wondered at. Galileo ancj
Darwin were primarily scientists, and all they asked wai;
to be let alone to do their work. Because of their partic
ular subject matter, they were not greatly interested ir
religious issues, and became so mainly to the end of try
ing to protect themselves and their scientific activitic*
from unwarranted interference. But with Freud the
situation was different. His subject matter was inherentlj
closer to that of religion; and if he was not to go alon§
with religion (as he obviously had no intention of dd
ing), then he had to go away from and against it, in a?
emphatic and militant a way as possible. Hence, as w^
have seen, he played the Devil.

But, much as we may sympathize with both the per
sonal and the historical situation which, as we may say
produced a Freud, we cannot at this point in time, regarc
his total effort as anything but a failure. In fact, thi
surely is the hallmark of Evil: ultimate disaster afte
what appears to be great accomplishment and gain. It i
the long haul that provides the test of Tightness anc
righteousness; and already, barely two decades afte

Psychotherapy and the Problem of Values 123

Freud's death, the signs of confusion and disintegration
in the movement he launched are rampant.

During the same two decades there has been a remark-
able upswing in church attendance and general religiosity.
But can we be sure that these developments have as yet
a clear ideology and rationale? There is still a babble of
tongues in respect to the genesis and treatment of those
profound and, alas, prevalent disturbances of the human
spirit which we doggedly dub mental illness. And the
contradictions between science and religion seem in many
ways as basic and irreconcilable as ever. But there is upon
the horizon a ray of hope which comes from as unlikely
a direction and is as altogether extraordinary as any of
the other developments which have been considered in
ithis paper.

i As a result of a succession of personal and professional
experiences whose narration will have to wait for another
occasion, I have become increasingly convinced, during
the last ten or fifteen years, of the basic unsoundness of
Freud's major premises and have, literally, read myself
back into a position which can be at least loosely iden-
tified as Judeo-Christian. However, it was only recently
that a book came into my hands which says, and says
very clearly and confidently, something which is wanting
in most contemporary religious literature and preaching.
I refer to Henry P. Van Dusen's book, Spirit, Son, and
Father (1958). I wish there were time to develop the
reasons why I feel such great excitement over this small
volume. Instead we must be content with the merest
intimation of what Dr. Van Dusen is saying. But first let
me state, what is of course well known to many, that
Henry Pitney Van Dusen is no upstart theologian or
fly-by-night scholar. He is currently President of Union
flTheological Seminary, in New York City, a member of
numerous important boards and foundations, and the
author or editor of some 18 other thoughtful books. And
Inow he comes forth with an argument which is absolutely
jrevolutionary and yet is as obvious and plausible as some-
ithing one has known all his life!

i The gist of this argument is that in our interpretation
^of the Christian Trinity, we have erred and confused
lourselves by making the order: God the Father, the Son,

124 The Crisis in Psychiatry and Religion

and the Holy Spirit. Van Dusen, paradoxically and yet
shrewdly, insists that the aspect of this trilogy which
has been least emphasized and understood is, in reality,
the most important and most immediately knowable.
"Something is lacking, and that which is lacking is what
is most important" (p. 11), he says with eloquent sim-
plicity. Dr. Van Dusen quickly gains the reader's con-
fidence and interest by acknowledging that he, along with
most laymen, had long regarded the concept of the Holy
Spirit, or Holy Ghost, as extremely vague and at least
mildly repulsive and unsavory. And yet, argues Van
Dusen, there are strong historical and Christian grounds
for believing that it is through the idea, indeed the ex-
periencej of the Holy Spirit that all other religious phe-
nomena and practices are inspired and validated. Then,
after citing a growing number of other writers who are
today also taking this point of view, he asks: "Is not this
the true message of 'Christian Hope* for which our gen-
eration longs?" (p. 11). 3

With such phrases as "omnipresence of the Divine in-
fluence," "immediately present and supernormally power-
ful," "the moral consciousness," "the very principle of
personal religion," "the Transcendent God in action,"
"the Immanent God in residence" and by reference to
the "inner light" of the Quakers, Buchman's "guidance
of the Spirit," and Kant's "categorical imperative of
duty," Dr. Van Dusen conveys something of the general
connotation which he would have us attach to the no-
tion of the Holy Spirit. He properly notes that it is at
this level of thought and experience that the "ecumenical
movement" on the part of various Christian denomina-
tions finds its soundest and most meaningful justification
— ^and to this he adds, even more broadly:

Here, then, is the elemental meeting-point of all religion
and the proper starting-point for a comparative study of the
faiths of mankind (p. 99).

A major, not to say insurmountable, stumbling block
to the acceptance of Christian orthodoxy for many con-;

®In correspondence, Dr. Van Dusen has called attention to
two other pertinent studies. They are Lindsey Dewar's The
Holy Spirit in Modern Thought (1959) and A. B. Gome's
Human Spirit and Holy Spirit (1959).

Psychotherapy and the Problem of Values 125

temporary men and women is the not uncommon insist-
ence upon the uniqueness and particularity of Christ and
of the Divine Revelation through Him. For the scientifi-
cally trained mind, order, regularity, and uniformity per-
vade the Universe; and suspension of natural law is as
unthinkable as is the episodic intervention of supernatural
powers and agencies. Hence, what the scientist looks for
in the realm of religion, if he looks for anything, is a set
of principles and concepts which are universally and
eternally applicable and operative. In Van Dusen's book,
what has previously been seen as perhaps least promising
in the Holy Trinity becomes actually the most promising
as the basis of a science-religion reconciliation. And the
significance and workability of this rapprochement be-
comes especially pointed when one examines, specifically,
the domain of psychopathology.

VII. THE HOLY SPIRIT, PSYCHOPATHOLOGY,
AND THE UNCONSCIOUS

As is of course well known, Freudian doctrine holds
that the impulses which are bottled up in the neurotic's
unconscious and there provide the wellsprings of psycho-
pathology are essentially "evil," i.e., they are, charac-
teristically, the impulses of hostility and lust.^ Granted
Ithis premise, the objective of analytic therapy is, logically
jenough, to release these impulses from repressive control
I — to let the evil out; and this is why therapy has been
[conceived at least metaphorically, as the Devil's work.
|In the neurotic individual, concern over virtue and
irightness of conduct has, presumably, done its work
only too well and has to be counteracted.

*This supposition is so widely known that it hardly needs
documentation; but since reference has already been made to
Freud's paper, "A Neurosis of Demoniacal Possession in the
Seventeenth Century," we may note the particular phrasing
which Freud there gives to it: "What in those days were
thought to be evil spirits to us are base and evil wishes, the
derivatives of impulses which have been rejected and repressed.
In one respect only do we not subscribe to the explanation of
these phenomena current in mediaeval times; we have aban-
doned the projection of them into the outer world, attributing
their origin instead to the inner life of the patient in whom
they manifest themselves" (p. 437).

126 The Crisis in Psychiatry and Religion

But now we are having to reconsider all this, and the
most likely alternative position is that neurosis is not a
result of blocked and outraged biological forces but is
rather an expression and consequence of "evil" in a very
different sense. The Freudians, of course, recognize that
guilt is central to neurosis, but it is always a guilt of the
future. It is not what the person has done that makes
him "ill" but rather what he wishes to do but dares not.
In contrast, the emerging alternative — or, more ac-
curately, the re-emerging one — is that the so-called neu-
rotic is a bona fide sinner, that his guilt is from the past
and real, and that his difficulties arise not from in-
hibitions but from actions which are clearly proscribed,
socially and morally, and which have been kept carefull}
concealed, unconfessed, and unredeemed. Freud's assump-
tion, consistent with the position just ascribed to him.
was that man is basically an animal, that his most funda-
mental nature is biologically ("instinctively") given, and
that it is cultural and moral interference with "things ol
the flesh" which make him emotionally sick. From man}
quarters now comes reaflSrmation of the view that mar
is preeminently a social being and that for him the su-
preme anguish comes, not from bodily deprivation oi
pain, but from the rupturing of his sociality which we
broadly denote by the word sin or alienation. For ex
ample, Dr. Karl Menninger (1958), after reading ".A
New Theory of Schizophrenia," which has already been
cited at the outset of this paper, wrote to say:

I very much liked the article. ... I wish you would tell
[the author] that I think it is fine and that it would be
even a little better, in my opinion, if he would not try tc
distinguish between schizophrenia and other groups of symp
toms. Essentially all mental illness must be a reaction tc
some kind of feeling of rupture with the social environmenl
. . . (personal communication).^

Clear adumbrations of this point of view can be traced
back nearly a quarter of a century. In 1936 Anton T,
Boisen published his epochal Exploration of the Innei
World, in which he postulated an outraged conscience
(rather than id) as the basis of neurosis and suggested

^For more extended statements of this point of view, see,
among others, Anderson (1959) and Jourard (1958).

Psychotherapy and the Problem of Values 127

that there is something potentially constructive and
growth-producing in such a state of mind. Two years
later, the erstwhile Freudian analyst, Wilhelm Stekel,
published a similar point of view in a book which did
not, however, become available in English and generally
known in this country until 1950. And in 1947-48 the
present writer, then unaware of the views of either Boisen
or Stekel, began the publication of a series of articles
(see Mowrer, 1950, 1953) in which repudiation and re-
pression of conscience, rather than id, was likewise
stressed. Now, again apparently independently of the
sources just cited. Bishop Arvid Runestam, of Sweden,
in 1958, published a book entitled Psychoanalysis and
Christianity,^ in which he writes:

The psychoanalytic theory about repression, and the wide-
j spread neuroses based thereon, . . . give the impression of
j a strong rancor on the part of psychoanalysis toward the
I needlessly strict censure of the life drive by contemporary
morality. . . . Psychoanalysis stands forth both in theory
and practice, by and large, as a potent promoter of the
right of the spontaneous instinct-guided life to make itself
effective. It is not as if it means that all morality is evil per
se. But morality presents itself more as a necessary evil than
as a positive good. Conscience and the "superego" receive
the role of operating purely negatively and restrictively on
that which alone appears to possess the right to life, "the
life stream" itself (p. 37).

However, there are two objections to the psychoanalytical
doctrine of repression. These, by the way, finally unite into
one. With reference to the notion that it is primarily the
sex instinct and the emotional energy it involves, which the
analysts imply have been unduly restrained, one may ask:
As one looks at the present situation and the contemporary
moral condition, is there anything that seems to indicate
that this drive has really suffered such terrible damage? On
the contrary, is it not at least plausible that the repression
leading to neurosis is caused by the repressing of other,
usually considered higher, instincts? Have the religious and
moral instincts — or, if we do not like to call them "in-
stincts," those factual, inherited or acquired religious and
moral forces, emotions, imaginings, needs — ^been treated more
mercifully by contemporary ruling powers than the lower

•This book is a revision and translation of a much earlier
Swedish edition, which appeared in 1932. For its day, the
wiginal version was prophetic indeed!

' 128 The Crisis in Psychiatry and Religion

instincts have? May it not be that these higher instincts,
needs, and forces, rehgious and moral, have suflfered damage,
and that repression and neuroses have their bases just in
this? (pp. 41-42).

Would it be too large a leap to equate or at least liken
The Unconscious, as reinterpreted by the writers just
cited, to the Holy Spirit, as Van Dusen conceives of it?
If such an identification (or even a partial one) can be
granted, a new and powerful basis is at hand for the in-
tegration of psychology and religion. Here is a force in
human personality and in the Universe whose manifesta-
tion and functioning can be scientifically studied and
which, at the same time (according to Van Dusen; see
also Boisen's reference to ''that social something called
God") is the heart and essence of religious experience.

How very different this conception is from the classical
Freudian one is indicated by the fact that where Freud
expected to find — and, with the aid of "diabolical"
strategies, release — Evil, we now believe the Holy Spirit
to reside! This changing view of the unconscious has
been more fully developed elsewhere [Chapters 2 and
8] and cannot be elaborated here. But enough has al-
ready been said to show how revolutionary all this is from
a theoretical standpoint; and it is not at all inconceivable
that corresponding reforms will follow in practice, in
both religious and psychological circles. Freud, as we havei
seen, did not take guilt seriously; it was instead in-
stinctual deprivation and frustration that concerned and
interested him. One is little short of dazzled by the pos-
sibilities that seem to lie before us if, for a change, w€
were to take guilt seriously and at the same time workec
out ways of dealing with it which are more realistic anc
effective than those which have characterized Protestant
ism and even Catholicism in its least vital forms.

In his book, Spirity Son and Father^ Van Dusen cite;
a "bold prophecy" made some years ago by F. D. Mau
rice to this effect:

"I cannot but think that the reformation in our day
which I expect to be more deep and searching than that o
the sixteenth century, will turn upon the Spirit's preseno
and life, as that did upon the Justification by the Son'
(p. 15).

Psychotherapy and the Problem of Values 129
And a few pages later Van Dusen himself remarks:

Time and again, the Holy Spirit has dropped from the
center of attention because it has been lost from the heart
of experience; theological crystallization and controversy have
preoccupied men's minds reliance upon creed and cult, upon
form and structure, has displaced expectation of new dis-
closures, sometimes with determinative influence and often
with baneful effect upon man's conception of the Holy
Spirit. Always, perhaps at long last, the Holy Spirit has re-
turned, first as an experience and secondarily as a doctrine,
to revive men's souls and banish their defeat and despair,
and then to reanimate the dead skeletons of ecclesiastical
organization and redeem the dry rot of dogma (pp. 27-28).

If psychology and religion can join forces, both con-
ceptually and practically, it is not beyond imagining that
we shall yet live to see men's souls revived and their de-
feat and despair vanquished.

10

Psychology, Theology,
and the Social Self *

Certainly the commonest and, in some ways, the most
serious objection to the notion that sin or real guilt is
the root cause of personality disturbances is that such a
state or condition cannot be objectively, scientifically
defined. What are the criteria, it is asked, according to
which we decide what is good or bad, virtue or evil? And
by implication, if a phenomenon can't be precisely, opera-
tionally defined, it doesnt exist. Many of us have very
much wanted to get rid of moral values, to believe that
reality is ethically neutral, and that experience or action
is good or bad only insofar as it is followed by pleasure
(lust) or displeasure (unlust). But gradually we are re-
discovering that there is more to human existence than
mere biology and that social systems {and, indeed, per-
sonality itself) cannot exist without prescribed and pro-
scribed patterns of feeling and conduct (cf. Chapter 3 ) .

After some preliminary considerations, we come to
grips in this chapter with at least one way of thinking
about the problem of ethics, operationally and objectively,
and of dispelling some of the wishful doubting in
which we have previously engaged. Here we also touch
upon the currently much-debated issue of conformity and
nonconformity. The charge that values and ethics are un-
scientific concepts (and therefore not to be taken se-
riously) seems to be giving way to the view that no
conception of personality and of society can be truly
scientific which ignores these considerations.

* The third of three lectures, on the general subject of
"Psychoanalysis and the Judeo-Christian Ethic," presented
February 23-25, 1960, under the auspices of the E. T. Earl
Lectureship Foundation and the Pastoral Conference of the
Pacific School of Religion, Berkeley, California.

130

Psychology, Theology, and Socl^ Self 131

In the first lecture in this series, I tried to show that
man is pre-eminently a social creature — or, in theological
phrase, a Child of God — and that his greatest anguish
comes, not from bodily discomfort or instinctual frustra-
tion, but from violation of his sociality, from estrange-
ment, from unacknowledged and unatoned real guilt.
And in the second lecture we examined some of the his-
torical reasons — or should we say, vagaries? — which
caused us to abandon this ancient and empirically-based
position and drift into the style of life epitomized by the
term 'Treudianism." It is now clear that, despite his
explicit disavowal of philosophical intent and his insist-
ence that he was merely a scientist and physician, Sig-
mund Freud actually conceived of himself as having a
messianic mission in the world and was aiming at nothing
less than a cultural and moral revolution.

But there are now widespread and growing indications
that the premises upon which this reformation was to be
founded are unsound and that Freud's aims and motiva-
tions were not messianic but demonic. We have good
reason to believe that psychopathology, instead of stem-
ming from unexpressed sex and hostility, comes rather
from an outraged conscience and violated sense of human
decency and responsibility. This radically revised percep-
tion of the basis and nature of mental illness suggests an
affinity with both classical and contemporary conceptions
of the Holy Spirit and points the way to a new synthesis
of religion and contemporary psychological and social
science.

How, then, shall we proceed in this, the third and final
lecture? Since the first two lectures were written some
months ago, I propose, first of all, that we briefly ex-
amine and evaluate inten^ening developments and then
decide upon the direction of our ensuing discussion.

I. FURTHER SIGNS OF THE COLLAPSE
OF FREUDIANISM

Although it is not particularly recent, I want to begin
by citing an invited address delivered to the American
Psychiatric Association in 1956, by Dr. Percival Bailey.
Dr. Bailey is Director of the Illinois State Psychopathic

132 The Crisis in Psychiatry and Religion

Institute; and his address, which has just come to my
attention, is entitled "The Great Psychiatric Revolution."
Here Dr. Bailey reluctantly expresses the opinion that
the so-called "psychiatric revolution" which was produced
by Freudian psychoanalysis has come to naught. He says:

The great revolution in psychiatry has solved few problems.
... I understand now why, in the last years, I have a!
recurrent dream that I am wandering through a dense path-
less forest but never arrive anywhere before I finally wake.
Lately I have another recurrent dream: A vine, seeking in
vain a support on which to climb to higher things, twines
around its own base (p. 402).

More specifically, Dr. Bailey says:

It has become a habit, in beginning a psychiatric lecture^
to pay tribute to Freud's genius. Thus Montague (1955),
in his dinner address to this Association, remarked: "This
general [pessimistic] viewpoint has received what is perhapsj
its most striking reinforcement from a source which undoubt-1
edly represents the most insightful contribution to our under-
standing of human nature in the history of humanity. I
refer to the psychoanalytic theories of Sigmund Freud," He
[Montague] then proceeds to demolish the viewpoint. .This
is an old procedure; Freud (Wortis, 1954) complained bit-
I terly of it. Still, his teachings continue to arise like a phoenix
from its ashes. Lately a psychologist was overheard at the
Chicago State Hospital expounding for the delectation of
the affiliate nursing students, on whom we spend thousands
of dollars every year to bring them to our hospitals, the
discredited theory of infantile parental incest in all its pristine
naivete. When one remembers how the teaching of Franz
Josef Gall still colors all our neurological thinking one
wonders how long the hoary errors of Freud will continue
to plague psychiatry (p. 395).

And Dr. Gamilla Anderson, staff psychiatrist at Salem
(Oregon) State Hospital (and author of a 1957 book
entitled, Beyond Freud) has, in like vein, remarked in
a recent letter: 'T cannot help but feel that the equation
of Freud with the devil [in the second lecture in this
series] is clinically sound and also socially. I believe that
we shall not soon overcome his pernicious influence."

Writing in the Reader's Digest for January, 1960,
Dr. H. J. Eysenck, Director of the Psychological Labo-
ratories of the Institute of Psychiatry at the University.

Psychology, Theology, and Soclu. Self 133

of London, in an article entitled, "What's the Truth
about Psychoanalysis?" points out that psychoanalysis is
no more effective in the cure of personality disorders than
the mere passage of an equivalent period of time would
be. Like Dr. Bailey, Eysenck also refers to the revolution
which analytic theory and practice supposedly brought
about in psychiatry and then observes laconically:

The success of the Freudian revolution seemed complete.
Only one thing went wrong: the patients did not get any
better (p. 40).'

Many of you will also have seen the 21 -page spread in
Look Magazine (for February 2, 1960) entitled *Tsy-
chiatry — The Troubled Science." And particularly sig-
nificant was the appearance, last year, of a book by Pro-
fessor Richard LaPiere, of the Department of Sociology
of Stanford University, entitled The Freudian Ethic. The
Saturday Review y for August 1, 1959, ran a six-page
Isynopsis of this book, entitled 'The Apathetic Ethic."
There are many arresting and quotable passages in this
synopsis (as in the book itself), but the following catches
the general tenor and flavor:

As a code of conduct the Freudian ethic, as it will be
termed hereafter, is entirely negative. It is composed of
sentiments and attitudes regarding man's capabilities which,
if literally applied, would keep him from attempting any-
thing positive, to say nothing of attempting to devise any-
thing new. Some appreciation of this state of mind can,
perhaps, be gained from the terminology used by those who
subscribe to it. In their discourse there is recurrent reference
to guilt feelings, personal insecurity, instability, frustration,
trauma, and "tensions." Such terms are used in reference not
only to recognizably abnormal individuals but to everyone.
Still more revealing is the total absence in the Freudian

^Analysts were always frank to admit their lack of success
ivith paranoid personalities and the addictions, including alco-
lolism. What conditions did this leave in which to achieve
heir so-called "triumphs"? Basically, anxiety states and depres-
jions, which tend to be naturally self-limiting and transitory
(though often recurrent). Thus, if a person is in analysis two
Dr three years, it is not unlikely that he will find himself feeling
1 good deal better. But there is serious question as to how
nuch credit analysis can take for it. The chances are the person
jvould have improved anyway. (Cf. Freud, 1937).

134 The Crisis in Psyciiutry and Religion

discourse of such terms as self-confidence, personal integrity,
self-reliance, responsibility, or such an earthy term as "guts"
(p. 40).

Also pertinent to our purposes is the following passage:

It is the thesis of this study that many of the changes
that have been of late years occurring in our society are
malfunctional and that they will, if they continue uncor-
rected, constitute our unrecognized road to disaster. These
changes are being wrought by men of many kinds and
various functions — by psychiatrists and child psychologists of
the Freudian persuasion, by permissive parents and progres-
sive teachers, by welfare workers and impressionable judges,
by managers of business and industry and leaders of labor
and academic life, and by politicians and political adminis-
trators of many sorts. Moreover, they are being demanded
or welcomed, or at least passively accepted, by almost every-
one (p. 44).^

Here I would suggest one or two not unimportant
emendations of Professor LaPiere's statement. By some;
odd coincidence, he fails to mention that professional
group which, just at present, is probably doing more than
any other to perpetuate what he calls the Freudian Ethic.
At a time when psychiatrists and psychologists are rather
generally abandoning psychoanalytic theory and practice,
ministers and theologians are, as a group, subtly or
stridently advocating it. I realize, of course, that there'
are many clergymen who are outstanding exceptions to
this observation; but as a profession, theologians are at
the moment, it seems, more heavily under the sway of
Freudian ideology than any other comparable group, in-
cluding psychologists and, quite possibly, even psy-
chiatrists [Chapters 4, 6, and 9].

The churches and the seminaries are, I believe, actually
in process of house cleaning and will presently recover
from this aberration. Recently, I had the privilege of
hearing a tape recording of the keynote address delivered,
in August of 1959, by Harvey Cox at the opening session
of the annual meeting of The National Student Councils

^ See also a series of three lectures entitled "Rake's Progress
in Religion" delivered by Dean R. E. Fitch during the 1960
Pastoral Conference of the Pacific School of Religion, Berkeley,
California.

Psychology, Theology, and Social Self 135

of the YMCA and YWCA. Allow me to quote an ex-
cerpt from this tape. Having cited the Columbia sociolo-
gist, C. Wright Mills, on the distinction between "trou-
bles" and "issues," to which we shall return presently.
Cox says:

As a student YM and YW, I think we have been smitten

by a hasty love affair with depth psychology, with troubles,

I with symptoms. Think of all the ink spilled over discovering

I myself, of unmasking and revealing each other's true and

J undisguised egos. I think we've had about enough of the

Who-am-I? bit. Think of the countless programs we've had

trying to answer this somewhat misleading question. And

then think just how far this is from Biblical radicalism.

I A member of the Salvation Army also recently gave me
1 quite remarkable piece of information. The "Army," it
ippears, keeps "statistics." And what do they show? Some
/ears ago this organization, along with religious denomi-
lations generally, decided that it was losing out on a
jood thing and that it, too, should go in for the "depth
psychology" alluded to by Mr. Cox. And what is the
esult? A steady decline in the effectiveness of this organi-
sation in salvaging lost, disorganized men and women. A
iirective has therefore gone out from the Commissioner,
it the Salvation Army's Headquarters in Chicago, to its
ichools and training centers to abandon the "depth" ap-
)roach and revert to its more traditional methods.^

There are, I believe, many similar trends in our more
;onventional religious denominations. But a confusing
lomplication exists here, namely, the unprecedented re-
lent upsurge in church attendance and membership. I
)ersonally do not doubt that this "return to religion" is
omewhat related to the renewed interest on the part of
ilergymen in personal problems — to the resurgence, that
s, of personal counseling, and of the impact of this inter-
;st upon the pulpit ministry. But I would ask you also
consider the alternative interpretation offered by
larvey Cox. He says:

For myself, the return to religion is only evidence on the
wrong side. I think most of it is simply a speed-up in the

'^Cf. God at the Scrap Heaps by H. F. Milans (1945) and
I. L. Brengle's Helps to Holiness (1948).

136 The Crisis in Psychiatry and Religion

anxious effort to cling to a 19th-century style of life which!
has on it the mark of futility.

And the fact that a person of my own persuasions has
been invited to give these lectures, here at the Pacific
School of Religion and the 38th Annual Pastoral Confer-
ence, this year is, it would seem, yet another indication of
the willingness of churchmen at least to entertain the pos-
sibility that they have been, literally, mis-taken in this
area and need to reconsider their own great traditions;
and indigenous potentialities. This is not, by any means,-
to say that all we need is simply to return to pre-Freudian
theology and doctrine. As I tried to indicate in the second
lecture, psychoanalysis came as a judgment upon 19th-
century religious ideology and practice. But we must not
take the judgment, the indictment, the curse itself as the
cure-^which, as I see it, is substantially what many thci
ologians have been disposed to do.

In short, what I have just suggested is that on-going
developments indicate, with every increasing clarity, the
steady deterioration of what Professor LaPiere has aptly
called the Freudian Ethic and that we have no choice
but to get about the business, at once, of finding some-
thing more suitable and substantial to take its place.
Conant's dictum that, in science, a theory is never over-
thrown by contradictory facts, only by another, better
theory, is well known. Surely empirical evidence tending
to refute Freud's basic assumptions has been lying pro-
fusely about all the time. But 19th-century theology had
manoeuvred itself into so many metaphysical absurdities
that when Freud came along with his brazen and bril-
liantly formulated heresies, the Church was no match for
him. Now we see Freud in a truer light, not as Messiah
but as Deceiver, and the Church will continue to pay
homage to him at its peril.

II. WHAT, THEN, SHALL WE DO TO BE SAVED?

For several years now, during the Summer Session at
the University of Illinois, I have taught a course in our
College of Education entitled ''Mental Hygiene foi
Teachers"; and when we get about half or two-thirds
through this course (which covers much of the same

Psychology, Theology, and Social Self 137

ground we have explored in these lectures, although more
systematically), students regularly begin asking: So what
can we do about the situation? As the diagnosis of our
predicament becomes clear, they begin asking about the
prognosis, the prescription for corrective action. In the
past I have been compelled to say that I did not know
the answer. But the situation is, I believe, gradually
becoming clarified. As I have already indicated [Chapter
i7], it would appear that the Church must become con-
cerned, in a new and more vital way, with the problem of
mental illness. No longer should it take a position of sub-
servience to a profession which, by its own admission,
has failed to solve this problem [see, for example. Chap-
ter 4]; instead, it must approach the problem indig-
enously, that is, in terms of religion's own great insights
and authority. And if its present precepts and principles
are not sufficient to this task, they must be modified and
revised until they are.

As part of such a program, it seems clear that we are
moving toward a reinstitution of regular confession in
the various Protestant denominations. 'Tastoral counsel-
ing" is merely a euphemism for a voluntary, nonprescrip-
tive form of confession; and this, if handled rightly, can
unquestionably be helpful — far more so, I believe, than it
ordinarily is at present. But we also need to move on
from the prevailing medical notion that one goes for
"help" or "treatment" only after one is in trouble, i.e.,
already "sick," to an active program of prevention; and
it is here that the obligatory aspect of confession takes
on special urgency. There is at present considerable
receptivity to this idea; and I should not be surprised
to see it effectively implemented in the near future,
particularly in Lutheran and Episcopal circles.

I realize, of course, that these statements, without the
full context from which they derive, may sound arbitrary
and, to some, perhaps even heretical; but in the Nyvall
Lectures this spring, I hope to develop this train of
'thought in a fully documented and more persuasive man-
ner [see Chapters 11 and 12].

What remains, then, for us to consider this evening?

I believe that in order to round out the argument and

ijanalysis launched in the first two lectures in this series

iwQ should employ the remainder of our time together

138 The Crisis in Psychiatry and Religion

along the following lines. For some decades now, we have
been in the habit, whenever a person was deeply troubled
and disturbed, of saying: He (or she) "needs therapy."
At last we are waking up to the fact that the "therapy"!
we have been so blandly prescribing for others (and our-i
selves) is fundamentally worthless — a "therapy" which
does not heal and which, as a general social philosophy
and guide to life, is downright pernicious. Now we are
beginning to realize that the commodity which practi-
tioners of this dubious art have been selling for $25 to
$50 an hour, or whatever the market will bear, is a snare
and delusion and that a radically different approach is
called for. Now, instead of talking just about "sick" in-
dividuals, we are beginning to talk about a sick society;
and I submit that an important aspect of this generalized
sickness is the very fact that we speak of our individual
and collective diflSculties as "sickness," rather than as sin
or evil. As Professor LaPiere has pointed out, sickness is
a stultifying and enervating concept; by contrast, there is
something salutory and vitalizing about the notion of evil.
It gives us, by implied antithesis, a new vision of the good
and something to work for, something positive and sub-
stantial on which Dr. Bailey's "vine" can cling and grow.
In short, then, it seems that what we have been calling
"therapy" itself needs "therapy," and when this becomes
the case, the nature of the problem shifts into a whole
new register, a different universe of discourse. Some years
ago, Rollo May (1953) pointed out that whenever there
is widespread need for individual psychotherapy in a.
society, there is an institutional and structural crisis in
that society. And Harvey Cox, in the address already
alluded to, develops this thought even more explicitly.
Having cited C. Wright Mills for the distinction between
troubles and issues, he says:

Troubles are personal, singular, and individual. Issues are
structural, general, pervasive. When one man can't get a
job, that's trouble; when six million men are out of work,
that's an issue. When an occasional couple can't make a
marriage work, that's trouble — maybe very serious trouble.
When the divorce rate climbs to a failure of one out of
three marriages, that's an issue.

Now I submit that in the psychiatry-religion area, we
are today confronted, not just by troubles — i.e., individ-

Psychology, Theology, and Social Self 139

ual failures to function within an essentially sound in-
stitutional and ideological framework — but by issues,
deep, pervasive questions of such urgency that, as Pro-
fessor LaPiere suggests, our collective as well as individual
survival may well depend upon the way in which we re-
spond to them. Therefore, in the time that remains this
evening, I propose that we continue our quest for clarifi-
cation of these issues, on the assumption that this is a
;necessary prelude to, or at least concomitant of, practical
reconstruction and reform.

In thus stressing the importance of intellectual analy-
|sis, I realize the danger of being taken in something of
a contradiction. On other occasions [see, for example.
Chapter 3], I have argued against the therapeutic impor-
itance of "insight" and sheer theoretical ''understand-
ing" in favor of concrete modifications of behavior. In-
formally, I have often cited an aphorism by E. Stanley
Jones to the effect that it is easier to act yourself into a
new way of thinking than to think yourself into a new
way of acting. And Lloyd Douglas commonly has char-
acters in his novels admonish others to seek the ''under-
standing" that comes, not from mere thought and talk,
but from actually trying out another life style and inter-
personal strategy. "Make an investment, perform an ex-
periment," is Douglas' terse way of putting it.

Now Jones, and Douglas, and Cox are not, I believe, in
the least disparaging the normal interplay of thought and
action. Rather are they rebelling against the interminable
rumination and "free association" that goes on in psy-
fchoanalysis and related procedures, with an explicit ban
on experimentation with new types of action, new pat-
terns of conduct and life style. During a classical Freud-
ian analysis, the patient is expressly forbidden to make
any major decisions or changes, in his life, on the
grounds that while the treatment is in process he will not
be competent to do so and might make serious mistakes.
The patient, while in treatment, may be encouraged to
"reality test" in the matter of greater expression of sex
and aggression; but anything so radical as turning over a
new leaf and trying to put one's moral house in order is
strenuously discouraged.

One of the many paradoxes that have beset psycho-
analysis is that while maintaining the essential irrational-

140 The Crisis in Psychiatry and Religion

ity of man, it put its supreme trust in verbal operations
and neglected the power of what G. H. Mead has called
the concrete social act. Small wonder, therefore, that
analysis often stretches out interminably and in the end
— if there is an end — leaves the analysand in an intel-
lectual and emotional morass. Somewhat parenthetically,
yet with all seriousness, I want to suggest that the com-
fortable and well-to-do classes in our society have been
trying to buy forms of personal redemption not nearly as
potent as those cures or "therapies" to which the poor
have always been limited. I am thinking not only of Al-
coholics Anonymous, but also of the dramatic transforma-
tions of men and women which the Salvation Army fre-
quently achieves; and there is even evidence — see for
example Boisen's book, Churches of Crisis and Custom
— that certain practices in the so-called sect churches are
drastic but potently restorative.* In other words, I am
suggesting that the time has come when we must recog-
nize that, in our efforts to purchase a form of salvation
which is supposedly better and less crude than anything
which the poor can afford, we have been, in effect, wast-
ing our money. There is no clear evidence of the efficacy
of professional psychotherapy — certainly nothing to com-
pare with the manifest transformations achieved by AA
and the Salvation Army; and I have often wondered if,
when we find we ''need therapy," we would not be better
off if, instead of getting a so-called therapist and paying
him a generous fee, we gave the same amount of money
each week to some really good cause.

A Swedish psychoanalyst, Dr. Nils Haak, who has written
extensively on the importance of high fees, says the belief

* I am thinking, for example, of a story which a minister
of one of the so-called sect or "fringe" denominations told
me recently of the way in which confession before his congre-
gation, demanded by the authorities of his group when he was
apprehended in homosexual practices, cured him of this per-
version, then and there, and laid the basis for successful mar-
riage and parenthood. In secular psychotherapy, by contrast,
we are ordinarily content with much smaller changes or "move- 1
ment." Some years ago a dramatic critic, in commenting on the
performance of Katharine Hepburn in a play, remarked that
she had run the emotional gamut "from A to B." A similar
characterization is in order with respect to the results of psycho-
therapy.

Psychology, Theology, and Social Self 141

that what is cheap is of httle value is deeply rooted in the
human mind. He argues that by demanding a high fee, the
analyst appears to the patient as a forthright individual who
dares to be honest about money. This makes the analyst a
fine person for the patient to emulate. A high fee, Haak
says, also prevents the patient from feeling infantile and
becoming dependent upon his analyst. For the neurotic
patient who likes to hurt himself, the making of large pay-
ments to the analyst, according to the Swedish doctor, is
an excellent outlet for neurotic feelings. If the analyst were
to allow the patient to pay only a small fee, it might give
him a humihating sense of gratitude that would interfere
with his therapy. There is also the attitude of the analyst
j to consider, according to Dr. Haak. If he charges a low
I - fee, the analyst may begin to doubt his own motives for
doing so. He might wonder whether he is in love with his
patient, or if he really hates the patient and is trying to
I cover up by being kind. This sort of thing can seriously
I interfere with the analyst's abihty to help (p. 45).

Some of you will no doubt recognize the foregoing
quotation as a part of R. H. Berg's recent article in Look
Magazine to which I made reference earlier. Another
argument which is sometimes advanced is that what the
analyst offers the patient is primarily his close attention
as the patient talks and that if he, the analyst, has any
financial worries he is likely to be distracted by his own
problems.

Dr. Haak conjectures that anything that comes cheap
is likely to be perceived as being of little value. More
pertinent to the situation would be the observation that
a commodity, such as psychoanalysis, can cost a lot and
still be worthless, except, as he implies, for the masochis-
tic or symptomatic relief it involves. I submit that if we
need to make a sacrifice, there are morally and socially
more relevant ways of doing this than supporting a psy-
phoanalyst in a penthouse.

I But this is something of a digression. The point I want
to make is this. Mere thinking, talking, analyzing will
not save us; our final redemption can only be found in
1 radically changed life style. The capacity to make such
1 change is often dependent, at least to some extent,
jpon new visions, new conceptions which we acquire
ntellectually; and it is upon this assumption that I sug-
gest we continue our attempt to clarify certain matters

142 The Crisis in Psychiatry and Religion

which currently seem to be the source of considerable
confusion.

III. THE PROBLEM OF EVIL
EMPIRICALLY IDENTIFIED

If a significant aspect of our great sickness as a people
and as a society is that we speak of sickness rather than
of sin, and guilt, and evil, then it follows that we must
reconsider these concepts. This, however, is not easy for
us. We are unaccustomed to thinking in these terms and
find them quite uncongenial. At the opening meeting of
a graduate seminar this semester, the very first question
raised by the students was: But what is guilt? Psycholo-
gists and psychiatrists, along with many religious leaders
and the general laity, have been taught to think in terms
of guilt feelings, that is to say, a sense of guilt which is
unrealistic and nonfunctional and which you can get rid
of only if you can find, and afford, a really ''good"
therapist. The notion that guilt is real and not to be
banished by mere talk or ''counseling" or "analysis" is
quite beyond our common comprehension.

Historians of the future may be able to discern more
clearly than we do today the circumstances which caused
us, as a people, to drift into this remarkable condition.
No doubt the true and complete explanation is complex;
but a prominent factor in the situation which I believe
we can already see with some clarity is that the traditional
guardians of our moral and spiritual values have insisted
upon speaking of these matters in terms and in a con-
text which are no longer very meaningful to the mental-
ity and thought forms of modern man. One of the rea-
sons, I believe, for the current popularity of Paul Tillich
as a theologian is that he has had the courage and dis-
cernment to be so nontheological in the conventional
sense of that term. Recently I met with a group of minis-
ters who quickly identified me, in their minds, as an un-
regenerate naturalist and not at all to their theological
taste; and a few hours later I met with a university faculty
group, in the same community, who perceived my posi-
tion as morally reactionary, unscientific, and, as far as
they were concerned, theological and supernaturalistic.
More than anything that has happened in a long time,

Psychology, Theology, and Social Self 143

this experience brought home to me the extent of our
diversity and confusion and our egregious lack of unity
in this area. This is not, I beHeve we would all agree, a
healthy state of affairs. There is, in our time, no social,
moral, and ethical solidarity and confidence. The diffi-
culty with the position of traditional theology is that its
logic and thought forms are foreign to the modern mind;
and the problem for the individual who is imbued with
what he believes to be a thoroughly scientific and objec-
tive world view is that he may be unable to find therein
any place for moral values, standards, and ethics. Tradi-
tional theology was the original thesis (if we may use
the familiar Hegelian paradigm); scientific naturalism
has been the strident antithesis; and from this clash
must come, I believe, a new synthesis of some kind
(Mowrer, 1959). I, personally, cannot envision this new
ethical frame of reference with great clarity; but there
is one facet of the picture which seems to me perfectly
definite.

There is, in our time, a widespread distrust of moral
injunctions and values which is at least rationalized by
the following argument. To be good, it is argued, is to
conform to existing rules and social prescriptions; and
these, it is pointed out, may be either outmoded or
otherwise nonfunctional; and if we obey them, then we
perpetuate them and so are not being good but, in
reality, stupid and evil.

Some years ago I recall a young married woman who
came to me in considerable distress because her husband,
with whom she was very much in love, "played around,"
as she put it, with other women when they went to
social parties. The husband, who also valued the marriage
and by no means wished to lose his wife, later agreed to
come in for a talk; and it soon came out that he justified
his philandering at parties on the grounds that he aspired
to be a writer and felt that he needed a little extra titilla-
tion and romance in order to be "creative."

In a sort of microcosm, this marital situation symbol-
izes at least a part of our larger problem: we pretend
to be afraid of convention and morality and social regula-
tion and order on the grounds that it will stifle so-called
rogress, invention, discovery, creativeness. One imme-
iately sees, of course, how easily such a formula can be

144 The Crisis in Psychiatry and Religion

used to justify and excuse the most blatant instances of
immaturity, selfishness, and moral laxity. There is, how-
ever, a legitimate side to this argument which must be
faced. Leaving aside those who are obviously exploiting
this dilemma in a personal way, there are many contem-
porary men and women who are sincerely wondering how
one can be good, in the sense of conforming to an es-
tablished social code or system, without also losing that
spontaneity and creativity which we so greatly value today
and regard as essential to meeting the unpredictable
needs of our changing civilization. Here, surely, is the
essence of our dilemma: on the one hand we seem to
find that the penalty for disregarding the rules of society
is mental illness and that, on the other hand, we must
preserve our freedom to change and try new ways of life.

Actually, I do not believe this paradox is half so diffi-
cult as we sometimes try to persuade ourselves, and so
suggest the following way of looking at it. Let us imagine
a man (which is not hard to do) who does not like to
pay his income tax. He has, as I see it, four alternatives:

L He can pay his tax, accurately and honestly, and
say nothing about his disgruntlement. He may feel that,
given the present state of world affairs, there is not much
he can do about the problem and that he is, in any event,
more interested in other things. Now despite the wide-
spread presumption (stemming from Freudian theory)
that it's bad for us not to express our annoyance, there
is not the slightest evidence that this sort of restraint
ever made anyone emotionally ill or destroyed his char-
acter. It may not be the most ''creative'^ way imaginable
of meeting situations of this kind, but it is at least a
perfectly respectable and safe one.

2. Or, a man, faced by the tax dilemma, can again
pay his taxes, accurately and honestly, but then make
whatever protest he feels is in order. In this particular
instance, he is likely to discover, rather quickly, that just
grumbling accomplishes little or nothing and that he
must look for the conditions and causes behind the
present tax situation. He may, as a result, become
staunch supporter of the United Nations, as a vehicle
for promoting greater international law and order, thus
lessening the threat of war and the necessity for ruinously
costly competition in the arms race. The point is that

Psychology, Theology, and Social Self 145

just because one scrupulously obeys a law or regulation
does not in the least mean that one cannot work —
openly, honorably, and effectively — for its modification.

3. Or, our hypothetical individual can pay none or
only a part of his income tax as an open and avowed
protest. He may be sent to prison for his pains; but we
must not forget that the method is an honest one and
can be extremely powerful. In modern times one of the
most dramatic examples of its effectiveness was the
campaign of nonviolent resistance to British rule which
Gandhi and his followers mobilized in India. The Indians
were oppressed, to mention only one example, by the
price of salt, which was a government monopoly, and
were forbidden (by what were known as the odious Salt
Laws) to make salt for themselves from the seawater
which was freely available to them. So Gandhi announced
that he was going to walk a distance of some hundred
and twenty miles to the sea and openly make salt in
defiance of the regulations of the British government;
and he invited others to join him, which they did by the
hundreds. "'When attacked, beaten, or imprisoned by
the officials, do not resist, do not flee, do not fight back,"
Gandhi urged. "Our oppressors will soon have no heart
for beating us further, and the Salt Laws will be re-
voked." As a result of this heroic March to the Sea,
as it is now called, the Salt Laws were revoked; and
eventually application of the same powerful strategy —
of open, nonviolent resistance — completely broke British
rule and resulted in a Free India. Here, surely, was a
power, a moral power, more effective than club, sword,
gun, or bomb. Limited nonconformity with openness,
integrity, and courage is available to us all, at all times;
and it can be as mighty as the mustard seed alluded to
by Christ in the parable.

I say limited nonconformity. Why limited? Because,
in the example given, Gandhi and his followers were, in
fact, scrupulously observing a higher law than the one
they were violating: they kept their honor, their openness,
their integrity — and the world respected and will not
soon forget them. This observation now leads us, by

I contrast, to the fourth way in which one may try to
deal with a rule or regulation which one finds incon-
venient or otherwise objectionable.

146 The Crisis in Psychiatry and Religion

4. Let us return to the income-tax example. Here the
individual again does not pay his tax or pays it only ;
partially, but then implies or claims that he has paid ;
it in full. His legal crime is thus compounded by deceit,
hypocrisy, and dishonor. And far from making a man I
strong, as Gandhi's Salt March did for those who took ;
part in it, this strategy destroys personality. In our time '
two seemingly unrelated things have happened: on the |
one hand, mental illness has defied our best efforts to i
understand and control it; and, on the other hand, we
have developed a widespread distrust of moral law and
principle. Only recently, within the last few years, have
we come to realize that there may here be a very vital
and important connection. Some of us now suspect
hidden guilt as being the central problem in all psycho
pathology. Integrity and integration, we note, come from
the same root: and it now appears that we cannot have
one without the other. Cheating and chiseling erode
character as they devitalize society. If we accept the
benefits and privileges of a given social system, then we
are honor-bound to observe the regulations and rules of
that system, unless we are willing to defy the system
openly and take the consequences thereof.

Obviously one can think of abnormal conditions such
as when a country is over-run by an enemy or such as
the Jews encountered in Nazi Germany in which all
manner of ethical dilemmas arise. But the circumstances
under which most of our crack-ups occur involve no
unusual or extenuating circumstances. Of course, we
hear much today about how our society as a whole is
"sick" and that one can survive only if one defies —
rather than obeys — it. This, again, seems to me to over-
look a very elementary distinction, namely, that between
personal sin and corporate sin. Vance Packard is entirely
correct when he points out that whereas we once looked
upon waste and conspicuous consumption as an evil, we
now are openly encouraged in it as an aid to an ''expand
ing economy." I believe that in our world the doctrine
of an "expanding economy" is an evil, but it is a cor
porate evil. By its very nature it is public, and we are all
more or less involved in it. The time will come, I predict,
when we are going to repent it bitterly; but I don't think
it's going to make anyone go crazy. The very fact that

Psychology, Theology, and Social Self 147

we are all in it together means that there is no loss of
sociahty, no estrangement from the significant others,
and so no madness.

By contrast, personal sins are those which the com-
munity does not condone, may in fact severely censure,
and which the individual, if he commits them at all,
commits privately, secretly. Blind and unwise as our
society may be in its current economic presuppositions,
it is still pretty well consolidated, it seems, with respect
to a lot of things; and it is in the areas in which virtually
everyone is at least overtly agreed that personal sin,
secrecy, and psychopathology follow in that order.^ Re-
cently I heard a state hospital psychiatrist comment on
how frequently incest figures in the background of the
patients whom she sees. Does anyone really think that
incest is a fine thing and ought to be generally practiced?
I doubt it. Yet it does occur, and I do not believe anyone
can long bind his guilt with respect to it by talking about
the moral absurdities and ambiguities "of society." Be-
sides, as I have tried to show, there is a perfectly straight-
forward way of fighting corporate sin without in the least
compromising oneself, i.e., falling into personal sin.
Personal sin occurs, as I see it, and sows the seed of
psychological destruction when and only when the in-
dividual violates a social injunction or regulation but
pretends that he has not.

I wish to conclude this section with a moving and
prophetic quotation from Dietrich Bonhoeffer. In his
book, Life Together, he says:

In confession the break-through to community takes
place. Sin demands to have a man by himself. It withdraws
him from the community. The more isolated a person is, the
more destructive will be the power of sin over him, and the
more deeply he becomes involved in it, the more disastrous
is his isolation. Sin wants to remain unknown. It shuns the

° Occasionally I have been invited to expatiate on the
concept of Original Sin. If I allowed myself to do so, I would
really lay myself open to the charge from theologians of prac-
ticing their profession without a license. But, for whatever it
may be worth, my untutored layman's opinion is that this
doctrine is nonsense, as is that of the Substitutionary Atone-
ment, and has done much harm in the world [cf. Chapters
11 and 12].

148 The Crisis in Psychiatry and Religion

light. In the darkness of the unexpressed it poisons the whole
being of a person (p. 112).

And Eric Fromm, in his book The Art of Loving,
says without equivocation, that the loss of relatedness
and community is the ground of anxiety and the begin-
ning of insanity (see also Kirkendall, 1960).

IV. A NATURALISTIC PARAPHRASE
OF PERDITION AND REDEMPTION

If the foregoing analysis is sound, the condition which i
we currently refer to as neurosis or psychosis is the same
as that which an earlier era knew as a state of sin or dis-
grace; and the defining characteristic of both is the
presence in one's life of shameful secrets. When Have-
lock Ellis was once asked what he thought of Freud's
ideas, he dismissed the question by saying that, in his
opinion, personality difficulties are due, not to the uncon-
scious, but to the unuttered. Freud's theory has, however,,
had a diabolical fascination for us; and it is only now
that we are beginning to realize how thoroughly mislead-
ing and destructive it is.

If it is indeed the untold rather than the unknown
that devastates us as persons and robs our lives of joy
and meaning, how can this view of the matter be given;
a theoretical formulation approaching in elegance and
plausibility that of psychoanalysis? In a moment I shall,
have a suggestion to make in this connection, but first a
collateral observation. When a neurotic (sinful?) person;
is asked, ''What makes you so anxious, so depressed, so
distraught?" he is likely to reply that he does not know.:
And the Freudian rejoinder is then, typically, "Yes, that
is true. You don*t know the causes of your troubles. ^
They are repressed, unconscious, and thus beyond your:
unaided capacity to deal with. How fortunate, therefore,'
that psychoanalysis is available to you as a method of
making the unconscious conscious and thus helping!
you discover the real origin of your difficulties and mak-
ing you then able to deal rationally with them."

I remember hearing John Dollard some years ago,
when we were both on the staff of the Yale Institute
of Human Relations, once remark that whatever Freud's

Psychology, Theology, and Social Self 149

scientific contributions might be, he had certainly started
a big business. Now, more clearly than before, we can
see the nature of that business. Certainly no one is going
to get rich telling others that their emotional turmoil
comes from unconfessed and unexpiated sin. That road
to redemption is too rough, and we shun even the
thought of it if we possibly can. The Freudian doctrine
is, of course, very different — far more pleasant sounding
and appealing. According to it, we are not "to blame"
for our suffering; but — and here is the joker — ^by the
same token neither can we do anything about our condi-
tion by ourselves. Only the psychoanalyst can save us;
and this he is very willing to do, he says, provided we
can pay him sufficiently well for his eflforts. For the poor,
as the Hollingshead-Redlich New Haven study has
shown, psychoanalysis has never been a live option; and
it is no accident that it is among them that we find other,
simpler, and more radically effective methods of salvation
at work. Also, as Bonhoeffer in his book. The Cost of
Discipleshipy has indicated, many Christian churches
have similarly tried to provide, for those who can afford
it, a doctrine of salvation through forgiveness uncom-
plicated by personal embarrassment, genuine contrition,
and meaningful restitution. This, Bonhoeffer has called
"the doctrine of cheap grace"; and because it is cheap,
in personal involvement, sacrifice, and change, it is no
grace at all. Despite its exorbitant fees, psychoanalysis
also preaches a doctrine of cheap, easy grace. If you can
only pay for it, buy it, someone else will do the real work
of curing you, while you lie comfortably on a couch.

One of the crying needs of our time, surely, is for a
therapeutic (redemptive) alternative which is available
to the well-to-do, without carrying the illusion that we
Can purchase it with mere money instead of at the per-
gonal cost which the poor have always had to accept.
Jesus Christ, we need to remind ourselves, was a poor
Itnan. He and his disciples moved about on foot, preached
land taught in the open, without benefit of costly church
or temple, and their appeal was to the poor. I. A. Rich-
ards once observed, ironically, that every profession is

conspiracy against the laity. The truth of this statement
lES regards psychoanalysis needs no elaboration. In a
'slightly more benign way, the same charge can, I believe,

150 The Crisis in Psychiatry and Religion

also be directed against theologians and clergymen. In
the Catholic Church, they openly claim to derive their
unique power to forgive sins as a result of the so-called
direct apostolic succession. And while making no such
claim in this area, Protestant theologians surround Chris-
tianity with other mysteries which only they can presum-
ably interpret. I take it as suggestive, again, that the
most radically redemptive enterprises which we today
know, notably the Salvation Army and Alcoholics Anony^
mous, are lay movements with their ''leaders" coming,
not from our universities and seminaries, but from the
Tanks of their own converted and transformed personnel.
Here the Priesthood of All Believers is more than a high-
sounding Reformation slogan; it is a living reality.

But to return, now, to the attempt to schematize the
strategy of deception and personal fraudulence which,
we conjecture, is the uniform precondition of emotional
or, as we might better say, moral disturbance. Freud
thought in vivid, graphic similes and communicated his
ideas, abhorrent though they were, in a clear and mem-
orable way. Only the parables of Christ himself compare
perhaps in trenchancy and heuristic aptness and are
actually inferior, at least by modern standards, as a con-
ceptual scheme. Hence, the task of formally systematizing
the alternative to Freudianism which seems to be emerg-
ing — or, rather, re-emerging — remains for the future. The
sociologist, George Herbert Mead, made some notable
steps in this direction, as did Harry Stack Sullivan within
the psychiatric framework and also Martin Buber, as i
theologian.'^ Here I shall make no attempt to revie>^
or synthesize their respective contributions but will in
stead suggest a heuristic device which I have found effec-
tive on other occasions.

In class one day I found myself drawing a straight line
across the blackboard, from left to right, as a means ol
depicting normal, upright day-to-day human living. A.
morally and emotionally healthy person, in commor
parlance, is said to be on the up-and-up, predictable
consistent, a straight shooter. This is not, of course, tc

"^ Of special interest in this connection is a book by P. E
Pfuetze which systematically relates and compares the writing:
of Mead and Buber. This book, significantly, is entitled Thi
Social Self. [See, also. Chapter 11.]

Psychology, Theology, and Social Self 151

say that such a person is perfect. From time to time,
even the best of men and women "stumble," "sHp/' or
momentarily "fall." But they know how to correct their
errors, how to pick themselves up, redeem themselves.
I once heard a colored attendant in a mental hospital
remark to a patient: "The Good Book says, when you
dowrij don't wallow!" And the psychiatrist, David Levy,

Fig. 1. A crude attempt to diagram normal and abnormal
life styles. The top horizontal line, with its occasional imperfec-
tions or "dips" but essentially straight course {from left to
right), represents ongoing existence in a normal, emotionally
and morally healthy individual. When such a person makes a
mistake, he corrects it and "goes on." But some individuals,
while pretending to be "on the level," allow themselves to "sink
\in sin," as shown by the descending, lower line. Because of the
danger, strain, and self -revulsion involved in such a "double
life," the individual eventually experiences a crisis {at X); his
sins "catch up" with him and he is overwhelmed by guilt and
anxiety. Now his option is a slow, painful "come-back" {as-
cending line) or further withdrawal from the whole human en-
terprise {descending broken line), in the form of suicide,
chronic paranoia, or general deterioration. The diagram could
perhaps be usefully elaborated to show how some persons, as a
result of crisis experience, also rise to "new heights." But, as it
stands, the diagram illustrates the most essential features of
the present analysis.

voices the same thought when he says that one of the
hallmarks of good character and emotional health is
resiliency, bounce. Therefore, I would modify the straight
line, as shown in the accompanying figure, so as to pro-
vide for periodic dips and recoveries, imperfections, dents,
but not nose dives.

However, not everyone has the strength of character
or wisdom to correct his mistakes, promptly and fully.

152 The Crisis in Psychiatry and Religion

which means that when he shps he takes a real plunge,
as shown by the lower line in the figure. Let me suggest
an illustration. A bank employee needs a little extra
money for a few weeks. He has access to stacks of cur-
rency which he knows will not otherwise be used during
this period so decides to "borrow" some of it, with the
full intention of replacing it. But his affairs do not move
as he had hoped, and he is unable to replace the money
and, in fact, soon finds himself in need of another ''loan."
And each time he thus illegally helps himself, it becomes
easier to do so again, the thought of restitution becomes:
more and more remote — and our friend is soon a con-
firmed embezzler.^

Now for a time things may go smoothly with this
fellow, and he may even regret his not having adopted
such a procedure earlier. But he is, of course, in constant
jeopardy, as indicated by the discrepancy between the top
line, which is what he pretends to be (namely, an honest
bank employee), and the bottom line, which represents
the level to which he himself knows he has sunk. Even-
tually, of course, something nearly always happens, and
our embezzler ''gets caught"; that is to say, there is a
crisiSf which is represented by the large X in the diagram.
Now the choice, if he has one, is between slow, painful
repayment or "restitution" (see the ascending line) and
criminal proceedings, imprisonment, disgrace, and, not
inconceivably, suicide (descending line).

Here the crime is a financial and legal one but it
nevertheless provides a good model for moral defection
and human "bankruptcy." Mistakes or sins of an inter-
personal character which are unacknowledged and unre-;
deemed also involve delinquency and deception; and
although things may seemingly go nicely for a time,
something likewise eventually happens which precipitates
a crisis, but now within the individual's own mind or
"soul" — and So-and-So, we say, has had a "nervous

® In a recent study, Cressey (1953) points out that a part
of the embezzler's "problem" is that it is "unsharable," This
state of affairs, it seems, characterizes many other situations
which get human beings into emotional or legal difficulties. It
is an essential feature of the present argument that no one eva
goes to prison or to a mental hospital who has (or had) noth-
ing "to hide."

.^

Psychology, Theology, and Social Self 153

breakdown." The fact is, he probably has been down
for some time, so that we could speak more properly of
an attack or outbreak of conscience. We say that the
individual has become mentally ill, emotionally sick, and
needs "treatment." But it is probably more discerning
to say that he has been ''sick" for quite some time and
that what we now perceive as manifest "illness" is really
an inner revulsion against a duplicitous and disgraceful
life style and an attempt, as Boisen would say, at correc-
tion and cure.^ I believe it is not inaccurate to posit
that virtually all of our contemporary efforts to deal with
the psychoneuroses are aimed at symptoms, and do not
get to the real root of the matter, and so remain ineffec-
tive. Note how often we speak of restoring the individual
to his former self, when not restoration but reformation
is what is needed.

As if at last awakening to the absurdity of this ap-
■ proach, we are beginning to ask again the question:
What is the true and ultimate nature of man? We
were willing, for a time, to accept Freud's dictum that
man is pre-eminently an animal, an organism, whose
ultimate destiny and fulfillment rests in his instinctual
life. This view we now distrust, and are rediscovering
man's inveterate sociality and morality. Freud said that
the alienation which is involved in personality disturb-
ance is between man's conscious mind and his body or,

° It goes without saying that a person does not necessarily risk
mental illness when he abandons one set of social and ethical
standards and drops down to a "lower" level of functioning. If
a person makes this sort of transition openly, we may say that
he is a "black sheep" or (in sociological jargon) downward
mobile; but since his defection is a matter of public knowl-
edge and carries its own natural and immediate consequences,
such a person's mental health is not in jeopardy. It is the per-
son who continues to lay claim to full membership in a group
whose standards he is secretly disregarding who is prey to "bad
, conscience" and "mental illness." Also, we should note that
"recovery" from such a state of affairs is never easy. As the
diagram illustrates, it is a decidedly "up-hill" business; and it
is totally unrealistic to encourage such persons, either in the
\ context of secular psychotherapy or religious conversion, to be-
I lieve that their "salvation" can be simple and easy. Salvation is,
nonetheless, possible; and it is our obligation to see and delin-
eate that possibility clearly and accurately.

154 The Crisis in Psychiatry and Religion

in terms of the title of one of his theoretically most
significant books, between The Ego and the Id. Our
perception is now changing and we see that the battle-
ground lies, rather, between the individual and, again to
quote Boisen, "that social something we call God."

Over the main entrance to Emerson Hall, which used
to house psychology and philosophy at Harvard, is en-
graved the Old Testament query or, more properly, awe-
inspired exclamation: "What is man that Thou art
mindful of him?" For a time it looked as if God had
forgotten us, as we had abandoned and turned away
from Him. But if it is indeed the Holy Spirit that is
working in us when we are "disturbed" and "emotion-
ally sick" [see Chapter 9], then God is very much with
us, indeed, and it behooves us to seek Him out on
friendlier terms, that we may be spared knowing Him
only in His Wrath and Vengeance.^^

I hope that none of you will feel that in these lectures
I am purporting to say anything new or original, except
in a very superficial and transitory way. One of Harry
Emerson Fosdick's published sermons is entitled "Redig-
ging Old Wells." And here Fosdick describes the great
watering places which the patriarch, Abraham, planned
and provided at strategic points in Palestine. When the
Philistines pillaged the land, these wells were despoiled
and filled; and Abraham's son, Isaac, made it his business
to re-open the well-springs of his father. Just because
something is old is no reason to think it is necessarily
unsound or inferior. Although I hold no brief for the
metaphysical baggage which the Judeo-Christian Ethic
has accumulated in the course of 2,000 years, I do main-
tain that this Ethic embodies some perduring verities
which we can today ignore only at our deadly peril.
Surely the author of the 139th Psalm glimpsed the
eternal when he wrote:

"It has become unfashionable (see also Chapter 5 to talk
about the wrath of God. I am indebted to Dr. Elmer Million
for calling to my attention the statement (by an unidentified
author) to the effect that the "wrath of God" is the way in
which those who oppose His will experience His love. The im-
plications of this way of viewing the matter for child-parent
relationships and practices are clear and illuminating.

Psychology, Theology, and Social Self 155

Whither shall I go from thy spirit? or whither shall I
flee from thy presence?

If I ascend up into heaven, thou art there: if I make
my bed in hell, behold, thou art there.

If I take the wings of the morning, and dwell in the
uttermost parts of the sea;

Even there shall thy hand lead me, and thy right hand
shall hold me.

If I say, surely the darkness shall cover me; even the
night shall be light about me.

Yea, the darkness hidest not from thee; but the night
shineth as the day: the darkness and the light are both
alike to thee. . . .

Search me, O God, and know my heart: try me, and
know my thoughts;

And see if there be any wicked way in me, and lead me
in the way everlasting.

And Francis Thompson, in the first stanza of his great
religious poem, "The Hound of Heaven," puts the same
thought no less majestically and with peculiar cogency
for our time, when he says:

I fled Him, down the nights and down the days;

I fled Him, down the arches of the years;
I fled Him down the labyrinthine ways

Of my own mind; and in the mist of tears
I hid from Him, and under running laughter.

Up vistaed hopes I sped;

And shot, precipited,
Adown Titanic glooms of chasmed fears,
From those strong Feet that followed, followed after.

But with unhurrying chase,

And umperturbed pace,
Deliberate speed, majestic instancy,

They beat — and a Voice beat

More instant than the Feet —
"All things betray thee, who betrayest Me."

II

Protestant Christianity:

I. Ambiguity and Disaster*

The title of Section II of this paper is "The Strange
Affinity of Protestant Christianity and Freudian Psycho-
analysis/' which might well serve as a subtitle for the
paper as a whole. Certainly the traditional precepts of
Christianity are not such as to lead one to expect a ready
assimilation of Freudian principles; yet such an assimila-
tion, astonishingly enough, has occurred — or, perhaps
more accurately, is being widely promoted. The situation
is thus extremely perplexing and problematic. Here, in
the present chapter, an effort is made to understand
this situation in terms of historical and cultural develop-
ments which date back at least to the Protestant Refor-
mation. It may, in fact, not be too bold to conjecture
that the Reformation, by its deficiencies and anomalies,
actually produced psychoanalysis. If so, it can be argued
with some cogency that the only way to extricate our-
selves from the dead end of Freudianism {see Chapter
10) is to continue the Reformation. As we shall see in
the last section of this chapter, there is actually wide-
spread and growing support for such a program, which
will be more fully elaborated in Chapter 12.

I. INTRODUCTION

There can, I believe, be no reasonable doubt that in
that area denoted by the terms Psychiatry and Religion,
we are today in a state of crisis. For the past several
decades we have been in the habit of saying to anyone

* Delivered at North Park College and Seminary on May 2 as
the first of the David Nyvall Lectures for 1960; also presented,
earlier, at a meeting held in Los Angeles, April 21, 1960, under
the auspices of the Department of Pastoral Care of the Hospi-:
tal of the Good Samaritan and later, in September as a Geehns
Lecture at the Southern Baptist Theological Seminary, in
Louisville, Kentucky.

156

Protestantism: i. Ambiguity and Disaster 157

who is in emotional difficulties, "You need therapy.'^
But now we are realizing that our so-called therapy is
itself sick and needs ''therapy" (cf. Chapter 10). As
long as we continue to believe that all is well in this
area and that all we need is more of the same, just
so long will we continue to spiral downward in a vicious
circle which, as Richard LaPiere (1959), Huston Smith
(1960), and others are suggesting, is bringing our very
civilization and established way of life into jeopardy.

Personality disorder of sufficient severity to require
hospitalization is today commonly acknowledged as the
nation's number-one "health problem"; and the preva-
lence of divorce, delinquency, suicide, perversion, and
addiction of various kinds — including the habitual use of
alcohol, tobacco, and various other tranquilizers — ^be-
speaks the widespread tensions and poor personality
integration in the populace at large.

Religion, to which we have traditionally looked for
redemption from evil and guidance in the good life has
all but abandoned its claim to competence in these
matters. To be sure, in recent decades there has been an
attempt, in the guise of the pastoral counseling move-
ment, to regain lost ground; but here the dominant ideas
bave been essentially secular; and when clergymen them-
selves have serious personality problems, they almost
invariably seek a secular therapist rather than depend
upon inspiration and direction from within their own
profession. On several occasions I have made the state-
ment that contemporary Protestantism has handled the
problem of personal guilt very poorly; and it is, 1 think,
tio accident that this assertion has not been seriously
challenged. For as long as Protestant clergymen preach
the Christian gospel on Sundays and then, on weekdays,
lave recourse to secular psychotherapists for help in the
management of their own lives, their message will have
ittle force or effect in stemming the tide of personal and
social disorganization in our time. As Anton T. Boisen
iDbserved more than 30 years ago, most Protestant reli-
i;ious leaders have allowed themselves to drift into a
bosition from which they can speak only as the scribes
pd Pharisees, not with authenticity and authority (see
Chapter 6). They proclaim certain tenets of Protestant

158 The Crisis in Psychiatry and Religion

doctrine, particularly of a Calvinist stripe, from their
pulpits, but seem completely unimpressed that this doc-
trine is not saving thertiy much less the persons to whom
they ostensibly minister. They preach justification by
faith and roundly condemn "good works," and seemingly
take no account of how poorly this doctrine itself works,
in the lives of modern men and women.

In August, 1956, a story appeared in Life Magazine
on "Why More and More Ministers Crack Up," ini
which the author maintained that the trouble lies simply
in overwork. Modern churches, he argued, make exces-i
sive demands of their ministers; and the solution sug-'
gested was for all churches of more than 500 members
to have two or more ministers, with a clearly defined
division of labor. While this is no doubt a good prac-
tical suggestion, it does not, I believe, get to the root of
the difficulty. The trouble basically is that the modern
clergyman is in an ambiguous and agonizing situation:
pretending to minister the Bread of Life to others and:
having no deep trust in it himself.

Here the inconsistency of the clergy is equalled only
by the audacity of the secular therapists to whom they
turn, not only for personal guidance but also for intel-
lectual inspiration and enlightenment. Although it has
been evident for at least 20 years that classical Freudian
psychoanalysis is a therapeutic fiasco, yet the assumptions
concerning the nature of man from which this form of
treatment was derived continue to be acclaimed as if
one could move the world with them. I don't know
how often, when I have criticized psychoanalysis, the
protest has come back: "But isn't it true that the super-
ego is overly severe in the neurotic individual and needs
to be softened, made less harsh and demanding?" It is?
true that this is what Freud saidy and a lot of people^
have tried to believe and apply this doctrine. But it is
public knowledge that both therapy and prevention!
which are based on this premise lead only to the most
dismal consequences; and one might suppose it wast
time that we stopped, for purely pragmatic reasons^
accepting the premise itself. If it doesn't work^ what is
there to make us think it is true, especially when it
contradicts some of the most basic principles of the
Judeo-Christian ethic?

Protestantism: i. Ambiguity and Disaster 159

ii. the strange affinity
of protestant christianity
and freudian psychoanalysis

For a long time it was a mystery to me why Protes-
tantism and Freudian psychoanalysis have hit it off so
well. In many ways they are very strange bedfellows
indeed. The New Testament, to say nothing of the Old,
seems fairly to cry out in opposition to everything which
psychoanalysis stands for; and Freud, in his book. The
Future of an Illusion, made his opposition to and con-
tempt for religion crystal clear [cf. Chapter 9]. Yet
present-day Protestantism and Freudian analysis are so
blended and interdigitated that it is hard to tell where
one ends and the other begins.

The total explanation of this astonishing state of
affairs is, I am sure, complicated. But do we not find
food for thought in the fact that both Protestantism,
insofar as it is Calvinistic, and the secular psychothera-
peutic enterprise, insofar as it is Freudian, equally stress
the helplessness of man? Calvin saddled us with the
doctrine of predestination and divine election; and Freud
spoke of psychic determinism and the tyranny of the
unconscious. Both would have us believe that we are
totally incapable of helping ourselves; and they differ
principally in the extent to which they hold us account-
able for the distressing predicaments in which we com-
monly find ourselves.

Protestantism has been curiously one-sided in its argu-
ment on this score. While holding that when we behave
badly it is by our own volition and choice, it then insists,
paradoxically, that when we behave well this is by the
grace of God, for which we deserve no credit. In other
words, the doctrine is that when we are confronted by
an apparent option of good and evil, we can choose
only the evil, and are fully accountable for having done
so; but if we do the good rather than the evil, this is
because of God's will and direction. In short, man can
willfully and deliberately act and work himself into a
state of perdition; but he cannot, by the reverse strategy,
save or redeem himself. Salvation comes, if it comes at
all, only by the grace and unpredictable favor of God.

160 The Crisis in Psychiatry and Religion

Small wonder, then, that such a doctrine leads to the
condition of uncertainty and ''despair" about which Soren i
Kierkegaard has written so poignantly in his Sickness \
unto Death and Attack upon Christendom. And it is, Ii
submit, this same despair that fostered the development!
and growth of Freudian psychoanalysis; for psychoanalysis \
takes the further step of making man irresponsible andi
unaccountable, not only for his salvation, but also for
his sins as well.

According to Freud the neurotic individual is helpless,
because certain of his problems have been relegated toi
and lost within the Unconscious Mind. But Freud was
at least more consistent and, in one sense, more benign.
Unlike Calvin, he held the individual accountable neither
for his salvation nor for his sin. As a child, the individual
who is destined to be neurotic as an adult, has sup-
posedly been so harshly and unreasonably treated by his
parents that he has no alternative but to repress certain
impulses, certain instincts; and it is this act of repression
or dissociation which lays the basis, according to Freud,
for that special misery called neurosis. Thus psycho-
analysis goes Protestant theology one better and makes
us not only unable to help ourselves in the matter of
"'recovery" but also blameless, and unaccountable, for
having gotten ourselves into our "neurotic predicament*
in the first place.

It is, therefore, not surprising that so many Protestant
clergymen, as well as the members of their congrega-
tions, have flocked to secular psychotherapists for "help."
The analyst not only gives a more definite promise of
salvation; he also holds us less "to blame" for our diffi-
culties. Calvinist Protestantism has said to us: "You are
responsible for your sins, but you are incapable of being
equally responsible for your redemption. God condemns
you for your evil, but He will pay no attention to your
own efforts to redeem yourself and will Himself save
you or not, according to His inscrutable pleasure." This,*
I submit, is a psychological and human absurdity and a
Christian deviation and perversity. But instead of rectify-
ing this perversity, we have compounded it by plunging
into psychoanalysis, which extends the heresy to its.
logical limits and takes away our responsibility, choice^i

ROTESTANTISM : I. AmBIGUITY AND DISASTER 161

id freedom not only with respect to our salvation but
so for our sin as well.

I. THE NEO-ORTHODOXY OF THE NEO-FREUDIANS

On other occasions I have documented the statement
lat there is not a shred of evidence that psychoana-
zed individuals permanently benefit from the experience
Chapters 1, 9, and 14]; and there are equally clear
dications that psychoanalysis, as a common philosophy
' life, is not only nontherapeutic but actively pernicious,
ere I shall not attempt to review the objective evidence
it will speak instead about the reactions of a psychiatrist
ith whom I recently had considerable contact at a
lall, intensive three-day conference. His position was,

effect, this. Yes, he agreed that psychoanalysis is un-
tisfactory. He had been trained in it, had applied it,
id could not make it work successfully and so had
landoned it for a different form of practice, for which
! had higher hopes. He could not, he admitted, prove

yet that his approach was superior to that of Freud;
it, he said, "people keep coming to you and you have
do something." And what precisely was this something
lich he was doing?

It turned out that his deviation from Freud consists
:gely in the fact that he does not require his patients

lie on a couch and does not observe certain other
-called "technical rules" of analysis; but he is still
vocating the basic Freudian premise that in neurosis
/hich I hold is just a medical euphemism for a state

unacknowledged and unredeemed real guilt), the
dividual is blaming and punishing himself quite un-
cessarily. As we grow up, this psychiatrist said, "we
come our own parents," which was his way of para-
irasing the Freudian notion that the conscience or
perego is an incorporation or introjection of our par-
ts' standards and values. And then he added, "We
ow the injustices to which we were subjected back
ere in our family. We know what the atmosphere in
r home was like. And yet we insist upon treating our-
ives, as adults, in the same harsh and unreasonable
ly our parents treated us as children."

162? The Crisis in Psychiatry and Religion

In insisting that our children develop a sense of guil
and the capacity to blame themselves, we pave the wa
for neurosis, according to this psychiatrist. And by sup
porting this kind of child training, the churches, he said
"are propagating a most vicious kind of mental ill healtV,
The churches create this type of attitude in people, an.]
I get the sweepings from it. I'm tired of seeing religiouj
parents and the churches teach children to tramp oi
themselves and would like to see this group take a;
official stand against such practices." We are ''divine,
the psychiatrist argued, and we have no right to tre£
ourselves in this way. And he blamed religious institi
tions for teaching a doctrine of sin, and guilt, and sel
condemnation instead of a doctrine of self-love, sel
forgiveness, and self-acceptance.

How unrealistic can we get? Conscience, that is to S£
the capacity for self-blame and self-punishment, is (
marvelous human and social invention, which has tl
highly adaptive function of causing us to "tramp c
ourselves" in order that others don't have to do th
for us. I know not a single reputable sociologist f
anthropologist who would seriously maintain that v
can have a society which does not internalize, as th
would say, the norms of the culture (Mowrer, 1961
Otherwise we have, not a society, not an organize
disciplined, orderly group, but an aggregate of psych
paths or, more accurately, sociopaths. And this is pi
cisely the direction in which classical psychoanalyl
theory and treatment and the so-called psychotherapeul
enterprise in general have been pushing us and the dire
tion in which we are actually moving. Was it not the ve
fact that the individuals involved in the 1959 televisi<
quiz-show scandals did not "tramp on themselves" th
permitted them to act as they did? This is only one]
dozens of similar illustrations of what happens whi
human beings refuse to "be their own parents" and
act as responsibly in their adult life as their parents tri
to teach them to act as children.

As indicated in the preceding section of this pap
Calvinist Protestantism took the first major step tow£
that brand of personal irresponsibility which is sociopatl
by making us supposedly powerless to do anything C(
structive about our guilt and sin; and then psychoanal}!

Protestantism: i. Ambiguity and Disaster 163

:ame along and took us the rest of the way by insisting
:hat not only can we not help ourselves move toward
:ecovery; we are wrong to blame or punish ourselves in
:he first place. We should love and accept and respect
Durselves so perfectly and so completely and so uncondi-
;ionally that we refuse to condemn, punish, "tramp on"
}urselves, no matter what! This, I submit, is not self-
respect. This is the ultimate in self-contempt and rejec-
don! For it requires us to regard ourselves, not as human
)eings, but as a variety of organism not basically different
TOm the beasts of field and jungle, with no morality, no
itandards, no character, no spirit. Who wants to lose his
Capacity to condemn and punish himself if he really
pehaves badly. This, surely, is the Pearl of Great Price;
md a so-called "therapist" who would take it from us
toes not respect us but despises us, himself, and the
vhole human enterprise. It is true, of course, that if we
lid not have the capacity for self-condemnation and self-
mnishment, we would never be neurotic or functionally
jsychotic, but neither can we be human without such
apacity. As Boisen (1936) has observed, susceptibility
this anguish is the price we pay, the risk we take, for
tur efforts to be something more than vegetables and
)easts. This is why I have said on other occasions [Chap-
ers 9 and 14] that psychoanalysis is not messianic but
iemonic, not salvation but slavery and bondage of the
/orst kind.

^. GUILT IS THE GREATEST EVIL

Following a lecture which I gave recently at the Uni-
ersity of California at Los Angeles [March 7, 1960],
)r. D. P. Boder made some extemporaneous comments
hich I found extremely illuminating and which I believe

can reproduce almost verbatim. He said:

The Freudian theory of emotional sickness and its treat-
ment is a direct outgrowth of the writings of the 19th-cen-
tury German nihilistic philosophers. Nietzsche, particularly
in his book The Genealogy of Morals, repeatedly affirms that
guilt is a weakness. And the poet Schiller, in his play, The
Bride of Massina, has the chorus end the play by speaking
these lines:

164 The Crisis in Psychiatry ai^ Religion

Life may not be the highest possession.

But guilt is the greatest evil. !

Since Protestant Christianity instills in us the capacity
to experience guilt but with no personal resource 05
reliable possibility for alleviating it, we can see why mer:
of intelligence and vitality began to think and utter such
outrageous ideas. And Freud, far from saving us frorr
this rebellion and despair, perfected and systematized it|
Today we are paying the price for having accepted this
ideology.

You will, I hope, realize that here I am speaking in j
highly generalized way. There are, perhaps, a few psy
chotherapists here and there who are practicing thei
profession along lines radically different from those lai(
down by Freud. But they have not as yet become ver
articulate in the professional literature and it is hard t(.
identify them. There are, of course, plenty of therapist
who are purportedly non-Freudian; but the majority o
these, I fear, are like the psychiatrist whom I cited earlier,
because they have abandoned classical Freudian tech
nique or some minor aspect of the theory, they cat
themselves non-Freudian, or neo-Freudian, or perhap
even anti-Freudian while continuing to accept the majo
premises of Freud's philosophy and thought.

The nondirective or client-centered type of therap;
which is associated with the name of Carl Rogers will
of course, be immediately thought of by many as "non
Freudian." But as I am here using the term, I woulc
say that Roger's approach is deeply "Freudian" (cf
Youngs, 1960). Like classical psychoanalysis, it begin
by not holding the individual personally responsible fo
his difficulties and gives him no prescription for dealinj
with them on his own initiative. Rogers views the in
dividual as inherently good and holds that he is coi
rupted and diverted from his indigenous growth ten
dencies along normal and healthy lines by the untowan
actions and attitudes of those around him. Here the en
couragement of self-pitying and hostile tendencies withii
the client is hardly less direct than it is in psychoanalysis
And although Rogers (1951) has seemed not to accep
Freud's doctrine of repression, he speaks of the ''denia
of experience" which, operationally, is not easily differen

Protestantism: i. Ambiguity and Disaster 165

tiated from dissociation or repression, thus re-afErming
the doctrine of the Unconscious and the individual's
essential helplessness with respect to it. I understand
from others who have recently worked with Dr. Rogers
that his views are in process of being revised; but as of
his best known and most recent public utterances, I
believe this appraisal is a reasonable and accurate one.

It can, of course, be objected that my strictures against
Protestantism are likewise not universally applicable. And
here the argument may take either of two directions.
Some will insist that I do not understand what Calvin
"really meant." Although I think I have a fair concep-
tion of what Calvin stood for (cf. Gilkey, 1960), I must
confess that I am not greatly concerned about the under-
standing of Calvin himself. What is important for our
purpose is the widespread popular conception of what he
meant; and I am therefore using "Calvinism" in much
the same way as I am "Freudianism." I can myself quote
excerpts from Freud's writings which seem categorically
to contradict the general position here (and popularly)
attributed to him. But the important thing is the main
thrust and impact of the thought of these men; and if
this does not in all details correspond to precisely what
they said (especially toward the latter periods of their
lives, when they had had a chance to reconsider a bit),
this does not particularly matter. We are concerned here
ivith cultural forces, and the very fact that I have chosen
to deal with both Freudianism and Calvinism as they are
bopularly understood is consistent with this aim and goal.

The second of the two types of objection referred to
I moment ago is this, namely, there are certain Funda-
nentalist or "sect" groups within the Protestant spectrum
vho have not "fallen" for Freudianism to the extent that
iberal Protestantism has. This I readily grant; but at
3nce we have to make a distinction between those groups
vhich are explicitly Calvinistic and those which are
iecidedly not. The Calvinistic sect groups are in much
he same position as was Protestantism in general before
he advent of liberalism and the infiltration of Freudian-
sm. They leave man with his guilt and do not attempt
:o deliver him from his "despair" by the Freudian for-
mula of making him not only helpless but also blameless,
pliey are thus, in one sense at least, in a sounder posi-

166 The Crisis in Psychiatry and Religion

tion than are the hberal Protestant groups and have, one
may say, less to repent. But they are still on the horns;
of the dilemma which Calvinism itself poses and do not
offer a satisfactory resting place. !

In contrast, there are some so-called sect groups whichi
preach and practice a form of Christian doctrine whichi
seems to me remarkably close to primitive Christianity
and which has been remarkably little affected by the
more dubious aspects of the Reformation, Later we shall)
have occasion to look again, more closely, at these groups,i
at the same time that we also consider the place ofi
Roman Catholicism and Judaism in the modern world?
[Chapter 12]. First, however, it will be necessary toi
review certain other considerations of a somewhat differ-*
ent nature.

V. SECULARIZATION AND CRISIS '

Before one can have anything like an adequate under-:
standing of the present crisis in psychiatry and religion,!
one must, I believe, carefully note the extent to which
numerous functions which prior to the Reformation were
regarded as the proper concern of the Church have
today been secularized. The Reformation was a valiant
effort to free mankind from the oppressive control and
domination previously exercised by the Church Universal.
And separation of Church and State, in as many areas-
as possible, was seen as basic to this enterprise.

Separation of Church and State in the area of politics
was, of course, a prime objective of the Reformation; and
we still have a strong feeling that religious groups should
"stay out" of politics, at least in the formal sense of the
term. Education has likewise been extensively secularized.
Our public schools are testimony to the success of this
movement, even though there is still resistance in some
quarters, both in theory and practice. The trend toward
secularization has also been marked in the area of charity.
Here we note the widespread development of public
relief, as well as numerous welfare agencies of a private
but, again, largly secular nature. The introduction of
insurance of various kinds has had a similar effect in this
connection: now, instead of giving directly to persons
who have suffered physical calamity, such as loss oi

Protestantism: i. Ambiguity and Disaster 167

lome by fire or flood, or incapacitating illness or death
n their family, we pay regular ''premiums" to a company
vhich carries out these functions, quite automatically
md impersonally, for us.

In these areas, then — of politics, education, and charity
—it looks as if separation of church and state, in some
legree at least, is here to stay. We shall later [Chapter
[2] have occasion to examine some of the less fortunate
consequences of the secularization of charity; and there
ire also those who point to evils that arise in public
education. But, by and large, the gains seem to exceed
he losses — at least this is the way the situation is popu-
arly perceived; and there is no strong inclination for our
ociety as a whole to revert to the earlier condition of
;hurch control in these areas.

There is, however, another area in which secularization
las occurred, with results which are far from satisfactory
)r reassuring. I refer to the management of the problem
)f personal guilt. Traditionally the solution to this prob-
em has rested very largely in the hands of the church;
md although Protestant and Catholic leaders alike con-
inue to lay claim to interest and competence in this
irea, the fact is that those persons who are most deeply
)urdened and broken by guilt and moral failure are now
[uite regularly turned over by the churches to the state
or "care and treatment." This statement, to be sure,
nvolves an assumption, namely, that in so-called men-
al illness or psychopathology the central problem is
;uilt, unconfessed and unatoned real guilt; but elsewhere
Chapters 3, 4, 5, 7, 8, 10, 14] I have assembled so much
evidence for believing this assumption to be justified
hat here I propose to take it for granted. On other
)ccasions [Chapters 9 and 10] I have also cited extensive
ividence for the assertion that the state mental hospital,
\s a therapeutic agency, is a failure and that the time
b upon us for re-thinking the whole attempt to help guilt-
idden persons in a secular, medically controlled setting.
I The phenomenon of legal guilt is manifestly a state
|esponsibility and probably should remain so, at least
nsofar as the determination of responsibility for specific
-Cts is concerned. But here again there is question as to
he success of the state's efforts at treatment and rehabili-
ation. Legally, retribution is the principal instrument of

168 The Crisis in Psychiatry and Religion

''justice," and as a deterrent to crime on the part of
others, it may be quite essential; but there is widespread'
disillusionment regarding its redemptive powers, and,
such writers as Albert Eglash (1958, 1959) are now sugi
gesting that prison programs ought to proceed muchi
more along lines of restitution rather than retribution.|

It appears, then, that secular, state-directed efforts tc;
rehabilitate guilty people — ^both those who have been,
legally adjudged guilty (i.e., criminals) and those who
(as Boisen has said) are seZ/-condemned (i.e., the insane)
— ^leave much to be desired. In both areas there has
been a widespread attempt, particularly under medical
aegis, to eliminate the whole notion of moral involve-
ment and to treat both groups as if they were sick. The
result is that we are now beginning to talk about our
whole society being "sick," and I have elsewhere sug-
gested [Chapter 10] that the essence of this "sickness"
is the undue extension into these areas of the sickness
concept itself.

But there is another side of this problem which is quite
as important as the one we have just been considering.
Religion, as an institution, can very possibly survive
without having a direct role in politics, or in education,
or perhaps even in charity in the material sense of that
term; but there is grave question as to whether religion
can survive, i.e., remain vital and meaningful, if it simi-
larly relinquishes its responsibility for ministering to those
who are devastated by personal guilt. I have previously
argued [Chapters 6, 7, 8], as Anton Boisen has done
for the past thirty-five years, that the church loses its
very excuse for existence and cuts itself off from essential
sources of inspiration and validation as soon as it refuses
to go "all the way" with the person who is in that emo-
tional and moral crisis which we call neurosis and psycho-
sis. As soon as the church turns such a person over to
some other agency or profession to deal with, it signs
and seals its own death warrant.

This view of the situation was brought home to me
with special cogency and force recently when I heard
a young minister use a purely hypothetical human situa-
tion to illustrate a point in theology, in a group where
a psychiatrist who was present was promptly able to cite
a real, flesh-and-blood "case" to the contrary. Boisen has

Protestantism: i. Ambiguity and Disaster 169

long pleaded with ministers and theologians to put their
books away for a season and to study those ''human docu-
ments" one finds in what he also colorfully calls "the
wilderness of the lost." This is not a great innovation or
departure for Judeo-Christianity; instead it is a challenge
to the churches to return to a depth of ministry which
they have generally abandoned. In the parable of the
lost sheep, Christ tells of the good shepherd leaving the
ninety and nine that are safely in the fold and going
to look for the one that has gone astray (Matt. 18:10).
Is it not the very fact that the modern church has become
indifferent to lost souls that has reduced its vitality and
authenticity almost to the vanishing point? As long as
ministers, priests, and rabbis are impelled and compelled
to "refer" and defer to psychologists and psychiatrists
when members of their congregations meet severe per-
sonal crises, just so long will they find themselves in the
predicaments described earlier in this paper.

Recently a college student, in a group where this
matter was under discussion, epitomized the situation
admirably as follows. She said: "Because the church has
refused to go after the one lost sheep, we now find that
we are all 'lost,' confused, neurotic."

VI. SHADOW OR SUBSTANCE?

I cannot claim to be at all fully informed regarding
contemporary trends in Protestant theology, but my cas-
ual impression here is of a land of shifting sands. Vogues
and fashions there are in abundance, but I fail to see
anything that looks much like the bedrock of perduring
human realities. One writer, by unusual eloquence, force,
or novelty, will gain a following, only to be superseded
by someone else who outdoes him at his own tricks. Just
at the moment Professor Paul Tillich is in the limelight.
I am not competent to judge much of what he has
written; but in the one area where I have some claim to
specialized knowledge I find him thoroughly ambiguous.
Take, for example, this passage from a recent sermon
entitled "The Good I Will, I Do Not":

In pulpits, Sunday schools and families, Christians have
called sinful the natural strivings of the living, growing and
self-propagating body. They concentrate in an inordinate,

170 The Crisis in Psychiatry and Religion

purely pagan way on the sexual differentiation of all life and
its possible distortions. Certainly, these distortions are as real
as the distortions of our spiritual life, for instance, pride and
indifference. But it is itself a distortion if the power of Sin
is seen in the sexual power of life as such. In this way, such
preaching completely misses the image of Sin as Paul depicted
it. What is worse, it produces in countless persons a distorted
guilt feeling which drives from doubt to anxiety, and from
anxiety to despair, and from despair to the escape into mental
illness and the desire to destroy oneself (p. 22).

What, precisely, is Tillich saying here? As is so typical
of many of his writings, this passage contains a number
of vague allusions and obscurities. But what Tillich seems
to be saying here, and over and over again in many other
places, is this: The Protestant church has given us an
acute capacity to feel guilt, quite unrealistically, with no
adequate means of resolving it. Therefore, with the Freu-
dians, he is suggesting that we reject guilt at its source
and thus not have to deal with it. Guilt, much of it
religiously inspired, he says, with Kierkegaard, Neitzsche,
Schiller, and Freud, is our sickness. In a recent letter
to a mutual friend, another distinguished seminary pro-
fessor takes a very different point of view. He says: "In
so far as Christians have fallen for the notion that guilt
is a sickness they have made theological donkeys of them-
selves. Much as I love and respect [Harry Emerson] Fos-
dick, I suspect he and others of his persuasion got them-
selves quite mixed up about *sin.' '*

Here, surely, is a hopeful note, but it is not in the
ascendancy today. It is not the vogue of the moment.
Today there are literally thousands of ministers who are
under the spell of Tillich, Fosdick, and the other Freu-
dian apologists. And what is the basis on which ministers
accept the leadership of such men? Is it because psycho-
analysis has been empirically validated? Not in the least.
It is rather because theology, by becoming bookish and
unredemptive, has lost its true center of gravity, its con-
tact with basic human realities, and its leaders bob about
like loose corks in a choppy sea. They turn to Freud
because they have lost their own integrity and anchorage.
If religious leaders had been deeply involved in the care
and redemption of seriously disturbed persons for the
past century, instead of systematically "referring" such

Protestantism: i. Ambiguity and Disaster 171

persons, there would have been no Freud and no neces-
sity for a Tilhch or a Fosdick to try to legitimize him!

Recently, at the conference to which I have previously
alluded, I heard seminar professors and distinguished
parish ministers make statements such as these: ''Today
pulpit theology is a bunch of words." ''Theology comes
between us and people." "The minister has trouble get-
ting his person and his profession together." "The church
must find a new form for its message."

I submit that the prime reason for this distressing state
of affairs is the fact that theology, i.e., the science and
art in which many of our ministers are trained, is un-
disciplined verbiage. By what operations is it validated,
tested, refined, clarified? What are the canons of evi-
dence which a minister uses for deciding what to preach
or write about? What are the rules according to which
he decides what is truth and what is error? Granted that
this is at best a difficult area in which to be wise, the
minister who merely reads, preaches, and perhaps does
a little pastoral counseling with carefully selected cases
can hardly be expected to have deep insights and to
inspire great confidence.

Challenge a parish minister or seminary professor to
stay with, rather than "refer," a person suffering from a
severe personality crisis, and what is the typical rejoinder:
"But Fm not qualified for that sort of thing!" The fact
is, such a minister is not qualified. Because the church
does not concern itself with the one genuinely lost sheep,
the whole congregation is eventually lost; and the min-
ister himself goes into "therapy" with the same would-be
secular healers to whom he has been referring others.
Today's clergyman can, I maintain, save himself only by
the radical expedient of returning to the full-fledged
business of saving, rescuing, redeeming others. And when
he does this, pulpit "theology" will recover the substance
and stability which are today so conspicuously lacking.
Here is one function which cannot be secularized, with-
out calamity to all concerned.

VII. THE REFORMATION MUST GO ON

Ladies and Gentlemen, I must acknowledge at this
juncture the surprise and, indeed, embarrassment I feel

172 The Crisis in Psychiatry and Religion

at finding myself, as a psychologist, playing the role of
theological and religious analyst and critic. The presump-
tion thus involved is, of course, enormous; and I venture
upon such a course only after having become persuaded
that the contemporary psychotherapeutic enterprise, and
its vagaries, cannot be understood without examining the
theological situation, in both its contemporary and his-
torical dimensions. Even so, if there were absolutely no
precedent among more competent scholars for the type
of reservations and concerns I am expressing, I might
still lack the necessary audacity to enter into such a
discussion. But the fact is, one finds considerable support
for this sort of thinking in the works of some of the most
distinguished theological writers of this generation.

In February of 1960, it was my privilege to hear the
lectures, on "The Christian Faith and Historical Think-
ing," which Dr. Wilhelm Pauck, Professor of Church
History at Union Theological Seminary, gave at the I
Pastoral Conference sponsored by the Pacific School of i
Religion, in Berkeley, California. Here Dr. Pauck re-i
minded his audience that the leaders of the Reformation ■
were of a decidedly medieval stamp of mind, and that;
their insights and truths are not necessarily pertinent or
applicable in our time. He pointed out that as a result of
this hiatus, "Christianity has become a minority move-j
ment" in the modern world and stoutly maintained that !
"The Reformation must go on." i

Almost immediately afterward, in the Christian Ccn-j
tury for March 2, Professor H. Richard Niebuhr, of the i
Yale Divinity School, published an article entitled, "Ref- j
ormation: Continuing Imperative." The first part of i
this paper is largely autobiographical and not particularly '
pertinent to our interests; but the later part is highly so i
and will be quoted at some length.

My primary purpose today is not to protest. It is still
that of the reformation of the church. I still believe that I
reformation is a permanent movement, that metanoia is the |
continuous demand made on us in historical life. The im- 1
mediate reformation of the church that I pray for, look for j
and want to work for in the time that may remain to me
is its reformation not now by separation from the world but
by a new entrance into it without conformity to it. I believe
our separation has gone far enough and that now we must

Protestantism: i. Ambiguity and Disaster 173

find new ways of doing what we were created to do. One side
of the situation is that represented by the "world" today, at
least the Western world. It seems to me that in that world
men have become deeply disillusioned about themselves and
are becoming disillusioned about their idols — the nations,
the spirit of technological civilization and so on. They no
longer expect the powers in them or around them to save
them from destruction (whether through holocaust or bore-
dom) or from the trivialization of an existence that might
as well not have been. The so-called underdeveloped nations
— including Russia — do not yet know that there is no hope
and no glory and no joy in the multiplications of our powers
over nature, and we have no way of saving them from going
through the experience through which we have passed or are
passing. But in the West the most sensitive, if not yet most,
men are living in a great religious void; their half-gods have
gone and the gods have not arrived. The religious revival we
are said to have had in recent years has been, so far as I can
see, less a revival of faith in God and of the hope of glory
than a revival of desire for faith and of a hope for hope.
And it further seems to me that our churches have been filled
(our seminaries too) with men and women who are experi-
encing that emptiness; further, that there is in the society at
large a host of similarly minded persons who have not even
considered the church as possibly ministering to their need.
I am haunted in the presence of that situation by the phrase:
*'the hungry sheep look up and are not fed" (p. 250).

Professor Niebuhr then calls for a "resymbolization
of the message and the life of faith in the One God"
and concludes by saying:

I do not know how this resymbolization in pregnant words
and in symbolic deeds (like the new words of the Reforma-
tion and the Puritan movement and the Great Awakening,
like the symbolic deeds of the Franciscans and the social
gospelers) will come about. I do count on the Holy Spirit
and I believe that the words and the deeds will come about.
I also believe, with both the prophets and, of all men, Karl
Marx, that the reformation of religion is the fundamental
reformation of society. And I believe that nothing very im-
portant for mankind will happen as a result of our "conquest"
of space or as a result of the cessation of the cold war unless
the human spirit is revived within itself (p. 251).

Such statements as those just quoted from Niebuhr
and Pauck not only underscore the general shakiness of
contemporary theology; they are also an open invitation

174 The Crisis in Psychiatry and Religion

to rethink our most fundamental presuppositions. But
they do not give us any very confident or clear indication
of the direction such thinking should take. Turning to
Tillich's book, The Protestant Era, a collection of essays
first issued in 1948 and reissued, in abridged form, in
1957, one finds little help in the earlier chapters; but
the book ends with a paper, initially published in 1939
in the American Journal of Sociology and entitled, 'The
End of the Protestant Era?" which is hard-hitting, direct,
and — up to a point — illuminating. The argument begins
thus:

The central principle of Protestantism is the doctrine of
justification by grace alone, which means that no individual
and no human group can claim a divine dignity for its moral
achievements, for its sacramental power, for its sanctity, or
for its doctrine. If, consciously or unconsciously, they make
such a claim, Protestantism requires that they be challenged
by the prophetic protest, which gives God alone absoluteness
and sanctity and denies every claim of human pride. This
protest against itself on the basis of an experience of God's
majesty constitutes the Protestant principle. This principle
holds for Lutheranism as well as for Calvinism and even for
modern Protestant denominationalism. It is the principle
which made the accidental name "Protestant" an essential
and symbolic name (p. 226).

And then Tillich says:

The consequences of the Protestant principle for intellec-
tual, moral, and social life are obvious. Protestantism is a
highly intellectualized religion. The minister's gown of today
is the professor's gown of the Middle Ages, symbolizing the
fact that the theological faculties as the interpreters of the
Bible became the ultimate authority in the Protestant
churches. But professors are intellectual authorities — i.e.,
authorities by virtue of skill in logical and scientific argu-
ment. This sort of authority is the exact opposite of the
kind that is sought by the disintegrated masses, whose dis-
integration is to some extent an echo of the endless argu-
ments and counterarguments among their leaders. Bishops,
priests, and monarchs have a sacramental authority which
cannot be taken away by arguments and which is independ-
ent of the intellectual and moral qualities of its carriers. It
is a character which can by no means be lost. This sacra-
mental basis is denied by the Protestant protest. The minister
is preacher, not priest; and sermons are intended, first of all,
to appeal to the intellect. But the masses that are dis-

Protestantism: i. Ambiguity and Disaster 175

integrated need symbols that are immediately understand-
able without the mediation of intellect. They need sacred
objectivities beyond the subjective quality of a preacher. . . .
More and more individuals become unable to endure the
tremendous responsibility of permanently having to decide in
intellectual and moral issues. The weight of this responsibil-
ity became so heavy that they could not endure it; and men-
tal diseases have become epidemic in the United States as
well as in Europe. In this situation, psychoanalysis has
seemed more desirable for educated people than religion,
especially Protestant religion. In Catholic countries the situa-
tion has been different because the confession has been able
to overcome many tendencies toward personal disintegration
(pp. 227-228).

Then, in a footnote, Tillich refers to the "success of
psychoanalysis in Protestant countries" which he at-
tributes to the assistance it gives the individual to ''bear
responsibility and guilt without the help of confession
and the related forgiveness which comes from the out-
side" (p. 228) . Here, it would seem, is where Paul Tillich
took the wrong turn in the road. Today we can say,
without fear of contradiction, that psychoanalysis has not
been a "success," in this or any other country. Yet many
theologians, including Tillich, continue to preach and
write as if Freudian theory and practice were the Alpha
and Omega. When, as in the Tillich sermon cited in the
preceding section, theologians today expound the psycho-
analytic doctrine of false guilt, they simply do not, from
a secular and scientific point of view, know what they
are talking about. This, among other reasons, is why I
say that secular students of this problem have no choice,
at the moment, but to strike out on their own in this
domain and make the best sense of it they can. And the
only way the present writer can understand the situation
is along lines suggested at the outset of this paper,
namely, in terms of the absurdity of the Reformation
doctrine of human guilt and divine grace. This, as I have
already argued, places man in an intolerable predicament,
from which psychoanalysis purportedly rescues him but,
in point of fact, only plunges him into the deeper. The
time has come, if we are not to march straight to perdi-
tion, to make an about-face and return to principles
which a perilous and arrogant theology has led us to
ignore and despise.

12

Protestant Qiristianity:

II. Challenge and Change*

If, as the last section of the preceding chapter suggests,
the Protestant Reformation was, in certain important
respects, deviant and incomplete, there is urgent necessity
for continued exploration, new insights, and social in-
ventiveness. But in an area as intricate and vital as the
one presently under consideration, ^'research" — in the
conventional sense of that term — is not very meaningful.
What is needed, instead, is broad trial and error, actual
experience, or * 'action research'' as it is sometimes called.
In the present chapter we review *' experiments'' of this
type that are already under way and suggest certain other
possibilities that deserve a hard try.

Surely one of the main reasons why, as Pauck (Chapter
11) says, the Reformation ''must go on" is the need to
bring science and religion into a common, or at least
cornpatible, universe of discourse. There is at present
some lack of sanguinity on this score, borne of the
consequences — already apparent to many — of our having
tried to make religion mesh with the pseudoscience of
Freudian psychoanalysis. We are now in process of get-
ting a clearer vision of psychological and social realities;
but Reformation theology has made its own distinctive
contributions to present confusion and has an obligation
to put its house in order, as well. To repeat a truism, a
sound psychology and a sound theology will show con-
gruence, not conflict, and should generate personal prac-
tices and institutional forms decidedly superior to those
we currently follow.

In this lecture I shall make no systematic attempt to
summarize the preceding one but will, instead, go directly

* Delivered, in somewhat abbreviated form, at North Park
College and Seminary on May 3 as Part II of the David Nyvall
Lectures for 1960 and also presented, as a Geehns Lecture, at
the Southern Baptist Theological Seminary.

176

Protestantism: ii. Challenge and Change 177

on with the main argument and analysis. However, I
shall try to do this in such a way that those who may
not have heard the first lecture will, by inference, quickly
identify the assumptions on which we are operating and
the objectives toward which we are aiming.

I. FALSE QUESTS FOR IDENTITY AND INTEGRITY

In the first lecture I mentioned having attended, a
few months ago, a very remarkable three-day conference.
The group consisted of ten or twelve eminent seminary
professors and parish ministers, with a sprinkling of
psychologists and psychiatrists. And although I thought
I knew something of the specialized, as well as common,
language of the professions thus represented, by the end
of the first day I was thoroughly mystified by what was
being said and done, especially by the theologians. Ob-
viously some new type of "group dynamics" was at work,
which I did not at all understand — or, I confess, like. We
had been called together (and were being paidl) to
consider ways and means whereby the modern church
can become more intelligent and effective in helping
modern men and women live confidently, meaningfully,
and creatively (in the best sense of that vastly over-
worked term). But this group was obsessed by a cultus
which was foreign to me personally and, as I perceived
it, irrelevant and negative as far as the stated objectives
of the meeting itself was concerned.

By the end of the second day, with everyone picking
at and on everyone else, as well as himself, and generat-
ing an impenetrable intellectual and emotional fog, a
little light began to dawn. Here, I surmised, were the
Existentialism of Paul Tillich and the I-Thou philosophy
of Martin Buber in action. My fellow conferees were, it
seemed, trying to put into effect, in their personal and
professional lives, what they understood these two specu-
lative giants to be advocating. But then a chance remark
provided a more specific cue; and when I returned home
I hurried to consult a book which I had owned for some
time but had not previously read: The Meaning of Per-
sons by Paul Tournier (1957). At once it was clear that
here was the manual which was inspiring and guiding the
strange demonstration I had witnessed — a sort of Latter-

178 The Crisis in Psychiatry and Religion

Day Pentecost, but with the thunder and bolts of fire
on a vastly reduced scale. The Fire, in fact, was mainly
smoke and the thunder, just "noise."

At this meeting a sort of pass-phrase which I heard
repeatedly, in slightly varied versions, was: "But I want
to get to know you, the real you." On the second page
of his first chapter (which has as a title what Harvey
Cox has recently characterized as "that hardly helpful
question. Who Am I?"), Tournier says:

Day after day men and women of all ages and conditions,
the healthy as well as the sick, come to see me in order to
learn to know themselves better. They tell me the story of
their lives. They take great trouble to get the details abso-
lutely right. They are seeking to know the person that they
themselves really are. . . .

What matters in this search for the person is not so much
historical facts as the way in which we see and feel them.
If our memories deceive us, the distortion that they have
undergone is by no means accidental; it tells us as much
about ourselves as do the facts themselves [italics added].

And a few pages later the author also says:

The reader will see now why it is that this problem of the
person has for twenty years been of such absorbing interest
to me. It has a general significance which is of vital im-
portance for all thought and all civilization: what is man?
But it also has a particular significance, which is equally im-
portant for my life: who am I, really, myself?

It is a question which haunts each one of us, whether we
are aware of it or not. It is there in every consultation I give.
It is there for the man who comes to see me, and for me as
well. This frank and living contact with people is the very
substance of my professional life. It is for me, quite as much j
as for the man who consults me, a means of discovering
myself. I seek to attain it not only in my consulting-room,!
but all the time, in every meeting with another person, in
my own family, with my friends, in conferences, and on a
holiday (p. 14).

And my friends were doing it, too, at the conference
— where, objectively, at least, they were supposed to be
doing something else! But objectivity, we soon discover,
is passe:

When we evoke our memories, we can never be quite sur^
that we have banished all illusion from them, howevei

Protestantism: ii. Challenge and Change 179

sincere we are. What we call to mind is not the facts them-
selves but their appearance, the way in which we saw and
felt them. All that we have seen and felt — images and sensa-
tions — remains more or less distorted in our memories (p.
12).

There was a tirrie when legend, poetry and music counted
for more than science in the making of a cultivated man.
, . . One of Pirandello's Six Characters in Search of an Au-
thor declares that an imaginary being like Sancho Panza is
more real than any real man. . . . Where then is the
frontier between what I am and what I can become? (p. 13) .

Even Sancho Panza is not identical for everybody; my idea
of him is not the same as yours, or as that of Cervantes.
. . . The same thing happens with all these people who
come to see me, and take so much trouble over their efforts
to describe themselves to me with strict accuracy (p. 14).

Twenty years earlier, we discover, Buber in his booklet
What Is Man? was making substantially the same point:

When imagining and illusions are over, the possible and
inevitable meeting of man with himself is able to take place
only as the meeting of the individual with his fellow-man —
and this is how it must take place. Only when the individual
knows the other in all his otherness as himself, as man, and
from there breaks through to the other, has he broken
through his solitude in a strict and transforming meeting.

It is obvious that such an event can only take place if the
person is stirred up as a person (pp. 201-202).

And precisely how is this to transpire? The answer:

In real conversation, ... a real lesson . . . , a real em-
brace and not one of mere habit, a real duel and not a mere
game — in all these what is essential does not take place in
each of the participants or in a neutral world which includes
the two and all other things; but it takes place between them
in the most precise sense, as it were in a dimension which is
accessible only to them both. Something happens to me —
that is a fact which can be exactly distributed between the
world and the soul, between an "outer" event and an "inner"
impression. But if I and another come up against one an-
other, "happen" to one another, . . . the sum does not
exactly divide, there is a remainder, somewhere, where the
souls end and the world has not yet begun, and this re-
mainder is what is essential. . . .

On the far side of the subjective, on this side of the ob-
jective, on the narrow ridge, where I and Thou meet, there
. is the realm of "between" (p. 204).

180 The Crisis in Psychiatry and Religion

This reality provides the starting-point for the philosophical
science of man; and from this point an advance may be
made on the one hand to a transformed understanding of
the person and on the other to a transformed understanding
of community. The central subject of this science is neither
the individual nor the collective but man with man (p. 205).

What, then, can one say to all this? There is something
undeniably appealing and wistful about it, but can it be
put to work in the everyday world? In the same context
from which the foregoing passages come, Buber refers to
"something ontic," and there is now in Chicago and one
or two other cities in this country an Onto-Analytic
Society. And various forms of Existential Analysis have
been practiced in Europe for some years. But is their
record any better than that of psychoanalysis? In an
oblique criticism of the latter, Buber writes:

We have seen that an individualistic anthropolgy, an an-
thropology which is substantially concerned only with the
relation of the human person to himself, with the relation
within this person between the spirit and its instincts, and
so on, cannot lead to a knowledge of man's being (p. 199,
italics added).

The emphasis on the relation of man-to-man is, surely,
an improvement upon Freudian doctrine; but is there not
still a serious ambiguity here? The emphasis, as Tour-
nier's phrasing especially suggests, is still upon one's
coming to know himself. Don't we, in fact, know our-
selves only too well and sicken of this knowledge, yet are
loath to let others know, in the same sense, who we are?
I do not mean "others" in the sense of a professional
listener who is paid to keep our secrets, but in Sullivan's
sense of the significant, ordinary others in our lives : rela-
tives, friends, colleagues, neighbors. Here is where the
real "break-through" to community and personal au-
thenticity comes; and anything which falls short of this
is, I submit, a pious hope.

II. PERSONS OR PRINCIPLES?

For the atmosphere created at the conference and the
prevailing tone of the quotations from Tournier and
Buber in the preceding section, there is surely only one

Protestantism: n. Challenge and Change 181

apt word: mystical. And since Orientals, rather than
Westerners, have cultivated the occult so much longer, it
is no accident that we should now be turning to them
for real expertness in these matters. Zen Buddhism has
already achieved at least a minor vogue in this country;
and recently a full-page ad by Harper and Brothers in the
Christian Century was headed: "Books on Eastern Reli-
gions for Western Readers." A few weeks ago a former
student, as a pleasant gesture, sent me a copy of The
Wisdom of Laotse (Lin Yutang, 1948). Laotse was a
Taoist, and Taoism is one of the direct and dominant
tributaries of Zen. Open the Laotse book, almost at
random, and here is the sort of thing one finds:

Life arises from death, and vice versa. Possibility arises
from impossibility, and vice versa. Affirmation is based upon
denial, and vice versa. Which being the case, the true Sage
rejects all distinctions and takes his refuge in Heaven (p. 49).

And to this intellectual nihilism is added moral nega-
tivism or at least neutrality. For example, we read:

The man of character lives at home without exercising his
mind and performs actions without worry. The notions of
right and wrong and the praise and blame of others do not
disturb him. When within the four seas all people can enjoy
themselves, that is happiness for him; when all people are
well provided, that is peace for him. Sorrowful in coun-
tenance, he looks like a baby who has lost his mother; ap-
pearing stupid, he goes about like one who has lost his way.
He has plenty of money to spend, and does not know where
it comes from. He drinks and eats just enough and does not
know where the food comes from. This is the demeanor of
the man of character (p. 129).

Now it is a good thing, surely, to have international
trade, both in the realm of material things and in ideas.
But when we start importing and extensively appropriat-
ing notions which by traditional Western standards are
patent nonsense, we need to look well to our condition.
If the line of thought we have pursued in the preceding
lecture and thus far in this one is sound, the facts run
something like this: The Calvinist doctrine of the guilt of
man and the grace of God (or what Tillich has called
the Protestant Principle) has been a heresy which has
produced despair, anger, and madness. Freud, with a

182 The Crisis in Psychiatry and Religion

great flourish of scientific objectivity and logic, pretended
to deliver us by going all the way and taking from us
responsibility both for our sins and our salvation. The
result: moral collapse and chaos! Now, feebly, in a sort
of hebephrenic languor, we are toying with Asiatic abstrac-
tions that make about as much sense as does modern ab-
stractionist art. Is this the best we can do? Perhaps,
but I believe there is an alternative way of approaching
the problem which we should consider very seriously:
namely, to assume that there are principles — universal,
consistent, knowable principles — in the domain of hu-
man personality and social process which transcend *'per-
sons," and that we can know others and be ourselves, in
the ultimate sense, only in terms of these principles.

Today we are hearing a great deal, in some quarters,
about God as person.^ But from the personal emphasis,
we easily move to the subjective; and, as we have just
seen, it is also but a short step from the subjective to
mysticism and chaos. For myself — and here I think I
speak for many others — what I want is a clearer knowledge

^For example, Hordern (1955), in describing the theological
position of William Temple, Archbishop of Canterbury, writes:
■"The supreme revelation is given in the life and person of
Jesus. The revelation is not his teaching or his acts but him-
self. . . . Christianity is not a dedication to a system of rules
or of thought, but a dedication to a person. This is unique
among the religions of the world" (p. 190). This emphasis
upon God-as-person is likely to strike the skeptic as a patent
absurdity; and it is also, it seems, of doubtful practical assist-
ance to the nominal believer when he is in emotional difficul-
ties. One can rebuild his life, in a constructive and satisfying
manner, along lines laid down by Christ's ethical teachings; but
the notion of the "mystical" union with Christ has, I submit,
little value save as a topic for endless theological disquisition. I
once took a young Polish psychologist (who was, I presume,
also something of a Communist) to the first Christian church
service he had ever attended; and afterwards, he was quiet for
a few minutes and then thoughtfully asked, "And what are
all those people going to do now?" What could I say? The
truth is there isn't much that a person can do about much
Protestant preaching, except to go back next week and hear
more of it. The de-emphasis on preaching and stress upon
action, deeds, works in the Catholic Church surely has some-
thing to recommend it. (Cf. a similar emphasis in the Mormon
and Moslem religions.) ^

■M

Protestantism: ii. Challenge and Change 183

of principles, which we can learn to obey and thereby
live abundantly or, if we choose, disobey and suffer the
consequences. A friend who is a state mental hospital
chaplain tells me that a point which he often makes with
patients is this: "We don't break God's laws. They
break us, if we disregard or defy them." Isn't this
what we need to know, more about how the Universe is
constructed and operated, in the psychological and moral
realm, so that we can conduct our lives more intelligently
and more meaningfully? If, in the physical realm, we
observe the Laws of Gravity, we get along nicely; if, on
the other hand, we disregard them, we may have a
broken neck to show for it. But do we "break" the prin-
ciples of gravity? Not in the least, they break us.

There is thus, as I see it, no place for Calvinistic logic
in the modern world: we have, it seems, a completely
symmetrical choice between observing natural principles
and prospering, on the one hand, and disregarding them
and getting into trouble, on the other. And we have
just as much responsibility — and deserve just as much
"credit," positive or negative — in the one case as in the
other. If we are to end the wasteful and undignified
conflict between scientific and religious world views, it
must surely be along these lines; and it is, I submit,
along the very same lines that the ecumenical movement
within religion itself also has the best prospects of suc-
cess. As long as different religious groups focus upon
personages, which are of necessity unique, they will
remain apart; but when they begin to look at the prin-
ciples which they have in common, reconciliation and
union are by no means improbable.

Especially interesting in this connection is another
passage from the article by Richard Niebuhr which I
have already [Chapter 11] cited. It reads as follows:

Experience and study [over the past 25 years] both have
led to some changes in the theological formulation of [my]
convictions. The complex, dynamic, interhuman as well as
the human-divine interaction of trust and loyalty has excited
my wonder and challenged my efforts to understand faith
more than ever. Perhaps it is this concentration on faith
as trust and loyalty which had led me farther away from the
road that many other postliberals — particularly Karl Barth —
have taken. So many of them seem to me to have gone back

184 The Crisis in Psychiatry and Religion

to orthodoxy as right teaching, right doctrine, and to faith
as fides, as assent; they tend, it seems to me, toward the
definition of Christian hfe in terms of right beheving, of
Christianity as the true rehgion, and otherwise toward the
assertion of the primacy of ideas over personal relations.
When I think about this I have to say to myself that impor-
tant as theological formulations are for me they are not the
primary one. I discover further a greater kinship with all
theologians of Christian experience than with the theolo-
gians of Christian doctrine. So I find myself, though with
many hesitations, closer to Edwards and Schleiermacher, to
Coleridge, Bushnell and Maurice than to Barth and the
dogmatic biblical theology current today in wide circles. To
state my understanding of our theological situation briefly: I
believe that the Barthian correction of the line of march
begun in Schleiermacher's day was absolutely essential, but
that it has become an over-correction and that Protestant
theology can minister to the church's life more effectively if
it resumes the general line of march represented by the evan-
gelical, empirical and critical movement. Some new studies
in modern theology have convinced me that the movement
from Schleiermacher to Troeltsch was by no means so hu-
manistic as its critics have asserted. Existentialism also has
served to reinforce my concern for the personal, for the reli-
giously experienced, for I-Thou relations between God and
man and between men. Among contemporary theologians it
is Bultmann who above all seems to me to represent this em-
pirical and ethical strain in theology (pp. 249-250, italics
added).

I

Here, as I see it, is an attempt to dissociate religio
from theological arrogance and abstraction and to relate
it to on-going human and social experience and need,
in a way which is immediately attractive to the person
with naturalistic, scientific, and humanistic predilections.
Here there is hope of finding principles of living on
which parish ministers and social scientists can deeply
agree. Here is an attempt, as Niebuhr explicitly states, to
make religion empirical, to validate it by its accomplish-
ments, instead of reducing it to a set of dogmatic as-
severations which are to be taken purely on faith, without
any reference to the consequences which flow from them
in the real world.

Niebuhr's emphasis upon the personal and interper-
sonal is, therefore, a very welcome one — and sound, pro-
vided it is interpreted and implemented in terms of

Protestantism: ii. Challenge and Change 185

definite principles, rather than as a "Cloud of Unknow-
ing" (to borrow the title of the anonymous book on
medieval Christian mysticism which Progoff, 1957, has
rendered into modern English ) . The need for a synthesis
of science and religion in the psychological and social
area is today very great, and here, in the realm of the
personal and the interpersonal, is manifestly the place to
begin. But this enterprise will not prosper if we rest con-
tent with the amorphous utterances of Buber, Tournier,
and other Existentialists or if we drift off into the frank
anti-intellectualism and ethical nihilism of certain Asiatic
philosophies. This is a capital challenge to both con-
temporary social scientists (see Mowrer, 1961) and to
clear-minded and courageous religious leaders, such as
Niebuhr.

III. SOME NONSENSE ABOUT SIN AND SINS

It is, of course, painfully clear that the obstacles to a
return to principle in the moral and spiritual realm are
formidable. From Luther down to this very day, there is
a subtle but powerful Protestant doctrine which is the
very antithesis of consistent, objective principle in this
area. Recently I heard a bright well-educated young
minister preach a sermon from which I wish to quote at
some length:

In the first place, we need to understand what it means to
say that we are sinners. Usually we mean by "sinner" some-
body who has broken a rule or violated a law, someone who
doesn't conform to accepted moral and social standards. . . .

But that isn't what sin means in the Bible! Sin is not the
accidental breaking of a rule, but the willful violation of a
personal relationship. We don't sin against rules, we sin
against persons. The Biblical God relates to his people not
primarily as a Judge to an offender, but as a Father to a son
who has rejected his love and wandered away into a far
country. Sin is what we were talking about last week. It is
the condition into which men meet each other from behind
masks, afraid to be known for what they are. Sin is when we
build walls of isolation and security to avoid the demand of
men to be loved as ourselves. Sin is the "thingification" of
persons — the using of human beings for what good they can
do us, rather than the seeking of genuine human community.
Sin is the ritual that allows us to glad-hand and smile and

186 The Crisis in Psychiatry and Religion

date without ever knowing the person we so casually "con-
tact." Have you ever been talking with someone and then
realized that you hadn't really heard a word he or she was
saying? Have you perhaps lived with a person and gone
through the motions of friendship or marriage and suddenly
realized you didn't really know him?

And now it isn't so easy to slough off our responsibility,
is it? We may never violate the commandments, but we
may know very well what it means to treat persons as things.
Listen to our poets, our dramatists, our sociologists, our
philosophers, our beatniks. They all speak with one voice,
and ask: ''How can we stop brushing by each other the way
we brush by a blackboard or a bush? How can we start
being human to each other?" That question shows that, by
whatever name it is called, sin is a reality to modern man.

Here we have it! Sin is not the grubby, mean, vicious,
duplicitous, self-defeating and socially destructive things
we do. It can't be that simple — otherwise, we would not
perhaps need so much preaching, so much explaining to
understand it. No, it is something much more compli-
cated, which only the professional theologian can fully
fathom. And this is what he preaches and teaches to the
laity, despite the fact that, as we have seen, when he
personally gets into emotional hot water, he finds it
precious little help, judging by the alactrity with which
he is likely to resort to a secular therapist of some sort
[see Chapter 11].

This distinction between sins and Sin was, of course,
stressed by Luther, during the Reformation, in his attack
upon the opposite emphasis of the Catholic Church.
But it has extensive roots back in the New Testament
itself in the writings of the Apostle Paul; and it is no ac-
cident that the sermon from which the foregoing quota-
tion is taken was buttressed by texts from the Letter to
the Ephesians, wherein the familiar Pauline doctrine of
justification by faith is expounded as follows:

But God, who is rich in mercy, out of the great love with
which he loved us, even when we were dead through our
trespasses, made us alive together with Christ (by grace you
have been saved), and raised us up with him, and made us
sit with him in the heavenly places in Christ Jesus, that in
the coming ages he might show the immeasurable riches of
his grace in kindness toward us in Christ Jesus. For by grace
you have been saved through faith, it is the gift of God — not

Protestantism: ii. Challenge and Change 187

because of works, lest any man should boast. For we are his
workmanship, created in Christ Jesus for good works, which
God prepared beforehand, that we should walk in them
(2:4-10).

But now in Christ Jesus you who once were far off have
been brought near in the blood of Christ. For he is our
peace, who has made us both one, and has broken down
the dividing wall of hostility, by abolishing in his flesh the
law of commandments and ordinances, that he might create
in himself one new man in place of the two, so making
peace, and might reconcile us both to God in one body
through the cross, thereby bringing the hostility to an end
(2:14-16).

Here, clearly, is Biblical authority for Luther's enig-
matic injunction to "Love God and sin boldly" (since
our sins are already forgiven before we commit them)
and, equally, for Calvin's doctrine of predestination
("which God prepared beforehand"). Paul (Ephesians
3:4) concedes that all this is "the mystery of Christ"
but claims he has "insight" into it. Can it be that the
mystery is largely of his own making and that although
he perhaps understood it, few have since been similarly
blessed.

It is not surprising, perhaps, that Lloyd C. Douglas,
while he was still a Congregationist minister, and before
he became a great novelist, often referred to Paul as
"that noisy troubadour from Tarsus!" Even though his
mellifluous phrases have rumbled on down through the
centuries, it is still not certain whether they make any
real sense. In Paul's own time, he had a trenchant critic
in the writer of the Epistle of James, who needs only
three and a half pages to refute the essence of what
Paul takes 88 pages, or nearly a third of the New Testa-
ment (RSV), to say.

What does it profit, my brethren, if a man says he has
faith but has not works? Can faith save him? If a brother or
sister is ill clad and in lack of daily food, and one of you say
to them, "Go in peace, be warm," what does it profit? So
faith by itself, if it has no works, is dead (2:14-17).

Show me your faith apart from your works, and I by my
works will show you my faith (2:18).

You see that a man is justified by works and not by faith
alone. And in the same way was not also Rahab the harlot
justified by works when she received the messengers and sent

188 The Crisis in Psychiatry and Religion

them out another way? For as the body apart from the
spirit is dead, so faith apart from works is dead (2:24-26).

Fundamentalists, literalists, and revelationists some-
times make a great point of the internal consistency of
the Bible. One need not be a Biblical expert to know
that James was in direct and emphatic disagreement with
Paul. And K. W. Lowther Clark, in his authorative Con-
cise Bible Commentary, adds: "The impulse [which
prompted the Epistle of James] was supplied by the
desire to recall Christians to reality in religion; [the
author] had seen the unfortunate impression made on
some minds by reports of St. Paul's teaching and wished
to counteract if (p. 915, italics added ).2

^ Since the above was written I have received a letter from
a clergyman of Calvinist persuasion which reads in part as
follows: "Ever since your opening address [see Chapter 8], I
have also wondered about something else which maybe you
could answer for me. If I remember correctly, it was your
belief that many times we make forgiveness too easy. Man has
worked his way into sin; he must somehow be given the op-
portunity to work his way out. Your reference to the old-
fashioned mourners' bench especially intrigued me. Could it be,
however, that this is due to the fact that we have separated the
doctrine of the substitutionary atonement from the offer of
forgiveness? I mean that if we preached, what I believe to be
the teaching of the Bible, that Christ was bearing the wrath of
God against sin, that he was being punished for my sin, that
we would not think of it as cheap and easy? I can never atone
for my sin, but Christ has done that for me. He has paid the
price. He bore the punishment due me; and my union with
him through faith means that my sins have been punished and
I can now have a clear, clean conscience." Here is an epitome
of the Great Idea which Reformation theologians spread
abroad in the world! If one is pleased with the present status
and prospects of Protestantism, after four hundred years, one
should by all means persevere in this ambiguous and bloody
doctrine. But for a growing minority (or is it now, in fact,
majority?), it just won't do. The discrepancy between the be-
liefs professed by many modern ministers from their pulpits
and their personal practices when in emotional difficulties has
been commented on in some detail in the first lecture of this
series. And a little later in the present discussion, we shall
allude, at least sketchily, to the much over-worked concept of
forgiveness. However, no attempt is made here [or elsewhere in
this volume] to deal in any systematic way with the whole

Protestantism: ii. Challenge and Change 189

Although the CathoHc Church has made a mystery
and a muddle of many things, in this issue between
Paul and James it has been clear-headed — and thoroughly
Jamesian. It has stressed the importance of good works
(as a means of correcting sins, without much reference
to Sin)y with implicit recognition of a "balance sheet" on
which our sins and virtues add algebraically. As Tillich
(1959) observes in the sermon previously cited:

Our moral balance sheet is not so bad as it would be with-
out these acts! And did you ever see a preacher of what is
called the "total depravity" of man who did not show in his
own behavior a reliance on a positive moral balance sheet?
(p. 17).

But the emphasis in the writings of Paul, and in Prot-
estant theology generally, has been on a very different
note, namely, that in the Substitutionary Atonement
(Christ's crucifixion), Cod wiped the ''balance sheet"
clean for all time and for all men, provided only that
they say, "I believe. . . ." In "accepting Christ as our
personal redeemer," sin is supposedly banished in our
lives and we are, from this point on, "saved." This is
what Deitrich Bonhoeffer, in his book The Cost of
Discipleship, dubs the doctrine of cheap grace, a doctrine
which has been a disgrace and a scandal to Christendom.
It is a doctrine which holds the deep natural wisdom of
the Judeo-Christian ethic in contempt — and prevents us
from coming to grips effectively with the most profound
personal problem of our time, mental illness.

IV. RETURN TO CONFESSION, WITH A DIFFERENCE

The crux of our present predicament, then, is that
Protestantism has embraced a theology which put the

notion of sacrifice, as a therapeutic force. Although Christ un-
doubtedly made a great personal sacrifice (of allowing himself
to be crucified for his conviction, rather than quietly slipping
off into the desert, as he easily could have), I believe a wholly
unjustified cult has grown up around this act which completely
distorts the historical facts and blinds our present-day percep-
tion in some vitally important areas. However, this topic is so
complex, and vital, that I am reserving it for special treatment
in a lecture to be given shortly at the Allan Memorial Institute
of Psychiatry, at McGill University, in Montreal. It will be
published separately, at a later date.

190 The Crisis in Psychiatry and Religion

problem of personal guilt beyond the scope of religion
and thus fostered the development of secular psycho-
therapy in general and Freudian psychoanalysis in partic-
ular. But analytic treatment and theory, far from lessen-
ing our woes, have exacerbated them; and we are today
looking to religion, once again, with renewed hope and
urgency. We have tried to believe that personality dis-
order is basically an illness — mental illness; but we are
now increasingly persuaded that the problem is funda-
mentally moral, that the guilt which is so obviously
central in psychopathology is real rather than false, and
that only a moral attack upon this problem can be suc-
cessful. We had hoped that an easy solution might be
found for personal evil; and we have tried both the doc-
trine of ''cheap grace" (in religion) and the strategy of
denying the reality of sin and guilt altogether (in psy-
choanalysis), but neither has worked. And so today
there is a growing readiness to accept the verdict that
''therapy," or "salvation," is possible only at great cost:
the cost of self-revelation, deep contrition, and a radi-
cally changed way of life.

The injunction to engage in auricular confession is
still to be found in the Protestant Episcopal Book of
Common Prayer; and a similar admonition is also present
in most forms of Lutheranism. However, the actual prac-
tice of confession has largely fallen into disuse in these
denominations; and among more radically Protestant
groups, confession has long been regarded as papish and
hence to be shunned like the plague. In the pastoral
counseling movement, there has, of course, been a sort of
half-hearted, disguised return of confession. But this
movement has been so dominated by ideas and tech-
niques which have been appropriated from secular forms
of psychotherapy that the results have been quite am-
biguous. Protestant churches must, I believe, rethink and
revitalize their efforts in this direction.

Luther, we should recall, was not protesting against the
institution of confession as such, but against its abuse.
Over the years, however, the assumption seems to have
developed that the only way to prevent this abuse is to
eliminate the institution itself. This is like arguing that
because surgery, in incompetent or unscrupulous hands,
can be misused, it should be eliminated altogether. Mani-

Protestantism: ii. Challenge and Change 191

festly some means must be found whereby ordinary
mortals can work through the problem of personal guilt
n a way which is more effective than anything which is
it present generally available. And the indications are
:hat confession, in a moral and religious context, is the
ogical starting point. In his book. Life Together, Deitrich
Bonhoeffer devotes the last chapter to the topic of "Con-
iession and Communion." Here he says:

"Confess your faults one to another" (Jas. 5:16). He who
is alone with his sin is utterly alone. It may be that Chris-
tians, notwithstanding corporate worship, common prayer^
and all their fellowship in service, may still be left to their
loneliness. The final break-through to fellowship does not
occur, because, though they have fellowship with one an-
other as believers and as devout people, they do not have fel-
lowship as the undevout, as sinners. The pious fellowship
permits no one to be a sinner. So everybody must conceal his
sin from himself and from the fellowship. We dare not be
sinners. Many Christians are unthinkably horrified when a
real sinner is suddenly discovered among the righteous. So we
remain alone with our sin, living in lies and hypocrisy. The
fact is that we are sinners! (p. 110).

In confession the break-through to community takes place.
Sin demands to have a man by himself. It withdraws him
from the community. The more isolated a person is, the
more destructive will be the power of sin over him, and the
more deeply he becomes involved in it, the more disastrous is
his isolation. Sin wants to remain unknown. It shuns the
light. In the darkness of the unexpressed it poisons the
whole being of a person. This can happen even in the midst
of a pious community. In confession the light of the Gospel
breaks into the darkness and seclusion of the heart. The sin
. must be brought into the light. The unexpressed must be
openly spoken and acknowledged. All that is secret and
hidden is made manifest. It is a hard struggle until the sin
is openly admitted. But God breaks gates of brass and bars
of iron (Ps. 107:16) (p. 112).

In his book The Riddle of Roman Catholicism, Jaro-
;lov Pelikan writes:

Through the administration of these three steps — contri-
tion, confession, and satisfaction — the church has a splendid
opportunity to apply the healing power of the gospel to the
concrete needs of the penitent. In the hands of a conscien-
tious pastor, the sacrament of penance makes divine grace

192 The Crisis in Psychiatry and Religion

meaningful without minimizing the individual's responsibil-
ity for his sin. It is, at its best, a truly evangelical means for
"the cure of souls," one whose benefits Protestantism has
discarded too easily, and one for which a friendly chat with
the minister is not a satisfactory substitute. Psychologically,
too, private confession is sound, enabling a person to "come
clean" about his feelings and to know that he has forgive-
ness from God in spite of anything he may have done. The
therapeutic value of this is difficult to overestimate (pp.
120-121).

And Meehl et at (1958), in their book What, Then,
Is Man?y take a similar position. They say:

One of the facets of confession which is often viewed
superficially in pastoral practice, or even ignored, is the de-
tailed or specific confession of actual sins. Many of the
Lutheran clergy do not minister to the needs of their parish-
ioners adequately because they are content when their peo-
ple participate in general confessions instead of insisting
upon the health-giving function of specific confessions, as
the Lutheran Catechism and standard works in Lutheran
pastoral theology recommend. The result has been that the
act of confession has become secularized. Educated people
especially seem more often to feel that their needs are better
met by psychoanalysis than the Word of God. Our pastors
ought to re-examine both the healing power of the Gospel
and the apparent self-sufficiency of their parishioners.

If the non-Christian psychotherapeutic effort has become
vastly greater in our society and has obtained enormous recog-
nition among our own people, it is in part the consequence
of superficial pastoral care. Though it must not become ex-
aggerated, so that it confers upon the pastor the role of
grand inquisitor, there is nonetheless such a thing as peniten-
tial discipline to which all Christians ought regularly to sub*
mit. Self-knowledge really exists only to the extent that one
does, or is able to, communicate it in speech to another
person. The psychotherapeutic value of making specific, or
even detailed, confessions is therefore very great (pp. 68-69).

As it happens the three writers just cited are all Lu-
therans. But men in other Protestant denominations have
made similar statements, some of them very much earlier
than the ones we have just reviewed. For example, Hol-
man (1943), in a review of H. E. Fosdick's book. On
Being a Real Person, wrote:

ROTESTANTISM: II. CHALLENGE AND ChANGE 193

Away back in 1927 Dr. Fosdick, then pastor of the Park
Avenue Baptist Church, New York City, gave an address
before the Greater New York Federation of Churches which
immediately brought expressions of angry resentment or warm
approval from Protestant ministers in all parts of the country.
Said Dr. Fosdick:

"We modern Protestants fail in some things. Our .
Roman Catholic brethren in keeping the confessional
have pretty nearly wiped us off the stage in one feature
of human service. . . .

*Tor six years I have conducted — Baptist though I am
— what I call a confessional. ... I have an office
where people who know they are spiritually sick and
mentally disturbed can come with their problems. Why
shouldn't I minister to them? Never again will I be
without such a place where people can meet me alone.
Week after week I meet nearly as many people as a
priest. They are mentally unbalanced — sick souls who
need ministration" (p. 214).

What, then, has thus far been the fruit of this grow-
[g awareness of the need for a return to confession in
le Protestant churches? Fosdick's early interests were, as
e know [Chapter 6], very largely absorbed and diverted
f the pastoral counseling movement, which has been
3minated by ideas taken from Freudian psychoanalysis
id the counseling methods of Carl Rogers. This move-
lent leaves much to be desired; and it is not without
gnificance that there is a new concern, on the part of
ich men as Bonhoeffer, Pelikan, and Meehl, with the
lerapeutic and redemptive potentialities of confession.
t the same time, however, there are some deep-seated
id at least partially justified reservations. We have con-
antly before us the fact that confession has long been,
id is still, practiced in the Catholic Church, with results
hich are not entirely reassuring. In later sections we
lall go into this problem in more detail; but here the
)llowing considerations are in order.

Whenever confession as a means of personal redemp-
on and change is under discussion, the question is sure
) be asked, and not unreasonably: Do Catholics enjoy
ly better mental health than do members of other reli-
ions or, for that matter, nonreligious persons? Mental
ospital statistics are likely to be quite ambiguous on this

194 The Crisis in Psychiatry and RELIGIO^

score. The religion of an entering patient, if any, wil
ordinarily be recorded without much reference tc
whether the individual has recently been religiously active
or inactive, thus obscuring the effects of the conscientiou:
observance, or disregard, of the tenets of his faith. Bui
there are independent indications — such as lower suicide
rates, lower divorce rates, and greater resistance to **battl(
fatigue" — that Catholics do have some advantage in thi:
connection. However, the difference is not dramatic.'
Catholics, laymen and members of the monastic anc
priestly orders alike, suffer from personality disturbance
both mild and severe, thus indicating that confessior
either does not have the redemptive and therapeutic
powers sometimes attributed to it or that — and here i:
the point of special interest — there are serious weaknesse
in the way confession is practiced by Catholics. I wish t(
discuss these weaknesses in the following order.

1. Catholic confession is often little more than at
empty, perfunctory formality. I have a friend who, whei
the occasion offers, makes a practice of sitting in Catholi(
Churches throughout the country and noting the tim<
which penitents spend in the confessional booth. Oi
the average it turns out to be about 60 seconds. And \
Catholic chaplain in a V. A. hospital recently volunteere(
the information that the confessions he hears from tb
patients who are entrusted to his care usually run from 4(
seconds to three minutes. Unless extensively supple,
mented by interviews outside the confessional, this typ.
of procedure can hardly be adequate to the needs of evei
ordinary persons, to say nothing of those who are in peij
sonality crisis. \

Priests vary enormously in the extent to which they arj
interested in the confessional. Many are frank to say thaj
they get through with this duty just as speedily as pos]
sible, in order to have more time for other concerns. Oi
the other hand, there are priests who give major attentioi
to this aspect of their work and who become widel;
known and sought after as confessors. These are th
men who are likely to become known as "spiritual direc
tors." But there is apparently no great pressure upoi

® There is, moreover, some indication that in Catholi
countries the incidence of suicide is not accurately reported
because of the great opprobrium associated with this act.

iotestantism: ii. Challenge and Change 195

iests to emphasize the confessional, except in its sacra-
ental aspects; and there is also, it seems, no scarcity of
ithoHc laymen who are as willing to handle their confes-
ms every bit as routinely as are many priests.

2. The penance assigned is often not psychologically
equate. Although I have not yet located documentary
oof for it, Catholic priests tell me that there was a
ne in the history of the Church when penances were
iich more severe than they are today and were more
arly designed to ''fit the crime." Now penance often
v^olves nothing more than saying some extra prayers and
rhaps burning a few candles. We know, of course, that
dividual human beings, when overwhelmed by remorse
d guilty fear, are inclined to be quite hard on them-
ives; and it is not surprising, therefore, that the pen-
ces assigned by the Church often leave the sinner in
Jtate of unassuaged personal guilt and anguish.

3. Confession is not an adequate deterrent. This criti-
;m is most often heard from non-Catholics, but Catho-
s themselves are not unaware of it as a problem. For
ample, a young priest once told me the following story,

one that circulates in Catholic circles. A peasant went
the village priest and said, ''Father, I have sinned."
f'es, my son," came the reply, "what is your sin?"
i'ather," said the peasant, "last night I stole a bale of
:aw. No, make that two bales, I want to get another
le tonight!"

Those who have been caught in a disgraceful deed or
10, from bad conscience, have had to make a painful
nfession thereof know that having one's failures and
ortcomings become known by significant others is, in
ct, an extremely powerful corrective of behavior. But
e fact that confession is not expected to go beyond
e priest and commonly involves a mere token penance
n hardly fail to limit its effectiveness both as a means
assuaging guilt and of deterring action when inner con-
3ls are weak.

4. Absolution and forgiveness are questionable proce-
ires. Protestant churches do not, of course, lay claim to
ipostolic succession" in the power to forgive sins; but
ey do preach a doctrine of divine forgiveness and ab-
lution of sorts. Let us examine this concept in a strictly
iman, interpersonal light. A few months ago, partly as

196 The Crisis in Psychiatry and Religioi

an inadvertence and partly out of slight exasperation, i
made a very unfortunate remark to a woman of my ao
quaintance. I immediately realized that she was emba!
rassed, and I was deeply remorseful. But I didn't attempi
any sort of apology, and she never said anything in th
way of "forgiveness." Nevertheless, after this incideni!
she was even more kindly and respectful in her behavici
with me than she had been before. I knew, therefon:
that she was not going to indulge in the luxury of beinl
resentful toward me or of rebuking me. She, manifestly!
had "forgiven" me in the sense of rising above the incj
dent herself; but this made my guilt and remorse eve!
greater, not less. I

This incident set me thinking about the logic and ps;|
chology of forgiveness in general. How can another, eitht
in a religious or purely personal setting, forgive us? ThI
misdeed, the sin is ours; and who would presume, an'
whom would we ask, to remove this responsibility? If wj
have erred, do we not wish to make restitution, insteai
of being "excused"? Forgiveness in the usual sense of th;
term is, I feel, an act of great condescension and not i\
all likely to restore either our self-respect or peace (I
mind.^

Therefore, in keeping with a greater emphasis on per
ance and meaningful restitution, I would like to see Pro;
estant churches, as they reconsider the institution of cor
fession, stress restitution and reform, not forgiveness. I
our consciences have enough rectitude to bother us whe
we act badly, I believe they will also approve and suppo
us when we have done the best we can to correct oi
misdeeds.

Extensive documentation of the psychological inad*
quacy of religious confession and assurance of forgivene
as commonly practiced is not readily available. But Meel
et ah, in the volume already cited, related the followin
incident:

A young woman confessed that she had broken the Se^
enth Commandment [Lutheran numbering; eighth in th
Reformed system] by pilfering ribbons and socks from

*In discussing this matter with a colleague recently, I wa
much interested in his opinion that forgiveness is "a profomr
irrelevancy in human affairs."

i^ROTESTANTISM: II. CHALLENGE AND ChANGE 197

dime store. She was obviously contrite about the transgres-
sion, and the pastor assured her of God's understanding and
gracious forgiveness. In a few weeks she was back in the study
to confess that she had stolen again, this time a few cents
from her mother's purse. Again absolution was pronounced.
When, not too many days after this, the girl again came in
tears, the pastor began looking more deeply. Professional help
was called in to assist the girl. Serious deficiences in her
home life were uncovered. It became apparent that she had
unexpressed misgivings about whether God had actually for-
given her after her previous confessions. While she had re-
pented of the sin that she knew, she recognized her inability
to straighten herself out; this feeling created internal doubts
about her confession. As these feelings were brought out and
she began to understand them, the urge to steal waned —
and the absolution was accepted and believed (p. 284).

Here we see, first of all, the inadequacy of the simple
ormula of confession and assurance of divine forgive-
less.^ The unfortunate behavior continued, so 'Trofes-
ional help was called in to assist the girl." What more
eloquent testimony could one ask of the loss of authority
md confidence on the part of the clergy than the tend-
;ncy to regard secular healers as the "professionals" in
his area? If, as we now increasingly suspect, moral issues
ire nuclear to every neurosis, isn't it remarkable that the
:lergy no longer regards itself as first in competence here?
n the particular instance cited, therapy along the familiar
ines of insight and understanding was ostensibly suc-
cessful. But, in the large, we know the picture is not a
jood one, that secular therapy predicated on the common
issumptions about repression, mistreatment, and the like
iocs not have a reassuring record; and this is why there
s a growing feeling that we should re-examine, revive,
fnd revise the institution of confession so as to make it
psychologically and ethically more meaningful and ade-
|uate. This, it seems, is a challenge that is pertinent not
)nly to the Protestant denominations but to Catholicism
[IS well.^

^See also Weatherhead (1957), especially Chapter 7, on
'The Difficulty of Feeling Forgiven."

"A recent newspaper report indicates that the Catholic
phurch has under consideration a proposal to increase the
everity of penances, to accord with earlier — ^and probably
oundei — ^practice.

198 The Crisis in Psychiatry and Religion

V. PROTESTANT (aND PSYCHIATRIC) OBJECTIONS
TO THE DOCTRINE OF GOOD WORKS
AND RESTITUTION

In the discussion period following another lecture, I
received this written question and comment:

How would you interpret Jesus' reference to the pharisees
as whited sepulchres — outwardly made beautiful and inside,
old bones and dead men's bodies? The outward beauty ob-
viously refers to the pharisees' assumed goodness and the
old bones and dead men's bodies must refer to repression
and undeveloped life.

The reference is here, of course, to Matthew 23:27;
and on many other occasions Christ rebuked the Pharisees
for their tendency to pray and give alms in public and
otherwise exhibit their piety. 'They have their reward,"
was his summary evaluation.

Those who are looking for it can, of course, easily find
here an apparent repudiation of the doctrine of good
works. But how, then, are we to interpret the story of the
Good Samaritan and dozens of other similar incidents
reported in the New Testament? No, clearly the objec-
tion is not to good deeds as such — far from it!, but to
boasting and exhibitionism with respect to the virtue or
credit thus achieved. But to this aspect of the problem
Christ, himself gave the solution: when you perform
charity, do it, as often as possible, in secret: "Let not
your left hand know what the right hand doeth." Is this
so hard to understand and practice?

As if the Bible itself were not sufficiently explicit on
this score, Lloyd Douglas, in both Magnificent Obsession
and Doctor Hudson's Secret Journal, elaborates and
dramatizes this point for us around the idea that reaL
''power," as he calls it, comes only when we do good:
by stealth. Dr. Hudson (the central character in both|
these books) holds that most of us live lives which are!
blighted by chronic insecurity, doubt, and despair because \
we characteristically display our virtues, and good deeds, j
and hide our sins and shortcomings. We are, so to say,^
chronically in debt and in danger. How, then, can we
resolve the situation? It is obvious, says Dr. Hudson:,

'kotestantism: ii. Challenge and Change 199

)isplay, admit, confess our sins and hide our good works,
uch a strategy, he argues, helps us, slowly but surely, to
love from anxiety, depression, and indecision to con-
dence, inner strength, and joy — or, as he calls it,
power."

Another argument which we often hear in this connec-
ion is this: "But many of our sins are of such a nature
iat we carCt atone for them." This, in the literal sense,
;, to be sure, often true. But we can try — and if we
ersevere long enough, knock hard enough, the door
ventually opens. The atonement or restitution doesn't,
f course, have to be "in kind," i.e., made precisely to the
erson who has been wronged or hurt, or be precisely on
le point of the original misdeed. There is always need
3r service of other kinds in the world; and who is to
ly that sacrifice for a good cause is less worthy as "justifi-
ation" than is a specific reparation?

Sometimes psychologists and psychiatrists who do per-
3nnel assessment work for seminaries and mission boards
'ill damn a candidate on the grounds that he is "moti-
ated by personal guilt." Is this necessarily bad? How
lany men and women, one wonders, have saved them-
dves from mental illness or worse by this very device?
'he important thing, I suspect, is that the individual be
lear-headed about what he is doing and why he is doing
:. If these conditions are met, I should be inclined to
xpect such a motivation to augur for success rather than
le reverse. What other type of motivation would we re-
ard as sounder? Or what better means of dealing with
ersonal guilt would we suggest?

Of course, the whole idea of atonement is foreign to
ur modern way of thinking about personality disturb-
nces. Such disturbances, we have been told and told
gain, come from false guilt, from lack of insight, from
ver-conscientiousness; so what is there to confess, much
jss realistically atone for? The "need for punishment"
1 neurotic individuals has, of course, long been recog-
ized; but it has been largely dismissed as the "masochis-
ic" aspect of neurosis itself. In other words, it too was
2en as irrational, a form of sickness rather than a sensible
nd healthy striving toward wholeness.

But the times are changing. Recently The Psychiatric
'bulletin of the University of Texas carried a feature

200 The Crisis in Psychiatry and Religion

article entitled "Retribution and Neurosis," the introduc-
tory paragraph of which reads as follows:

In many kinds of emotional illness or maladjustment, guilt,
whether conscious or unrecognized, coexists with an assump
tion of punishment. Sometimes any disorder or event is inter
preted as such. Patients may feel doomed or fated to undergo
some tragedy or committed to a course of action that wil
culminate in disaster. Others may explain a chronic illnes!
or develop a functional one as a retributive measure. Twc
related versions of this manifestation are described as the
talion principle and the nemesis concept (p. 16).

There then follows a discussion of the talion anc
nemesis principles, which I assume are well known. Bui
in a section entitled "Treatment," a new note is struck
Here there is no reference to the classical Freudian doc
trine of false guilt as basic to neurotic difficulties. In
stead we read:

Patients may be anxious, phobic, or obsessive, for example
but their basic fear is also their method of coping with th(
discomfort caused by their unresolved guilt.

And in conclusion the author says :

A nineteenth-century physician Abraham Coles, wrote o
"the inappeasable Nemesis within." He was speaking of th(
guilty conscience. In this way the individual meets his owi
guilt feelings; ideas of retribution may figure strongly. Patient
require psychotherapeutic help, both for their psychosomatii
ailments and for alleviation of such fears as may be explainec
away. In obsessional cases or in severe instances in which thi
concept of retribution affects all phases of the patient's living
referral for psychiatric treatment is needed (p. 17).

If the reader senses some ambiguity here, it will not b(
surprising. What is the author really saying? On the on(
hand, he seems to be saying, or at least implying, that ii
neurosis, guilt is (always?) real, with a justifiable expecta
tion of impending punishment or retribution of som(
sort. But also he is suggesting that such fears may some
times be "explained away"; and if not, that they can b(
dealt with by established psychiatric methods. It is no
clear what methods modern psychiatry has for dealing
with real guilt. But the title of this article at least carrie:
the implication that restitution might be an alternative

Protestantism: ii. Challenge and Change 201

the retribution which is often associated with neurotic
endencies. Here is a new trend in contemporary psy-
chiatric thought, which is further underscored by the
following lines, quoted by the author, from Byron's
'Childe Harold's Pilgrimage":

Meantime I seek no sympathies, nor need;
The thorns which I have reap'd are of the

tree
I planted, — they have torn me — and I

bleed;
I should have known what fruit would

spring from such a seed.

It sounds as if at least some psychiatrists are beginning
:o take guilt seriously. This is a hopeful and constructive
}ign.

VI. confession: sacrament or therapy? —

THE catholic POSITION

i

In the Catholic Church, confession and the associated
acts of contrition and attrition (remorse and penance)
are first and foremost a sacrament: means, that is, of
bringing one's immortal soul from a state of sin to grace
and thus averting the dangers of Hell. But on the ques-
tion of whether confession is also emotionally and psy-
chologically helpful in this life, the Church is officially
silent, with the views of individual Catholic writers cov-
ering the full spectrum from strong affirmation to em-
phatic denial.

If present presuppositions are valid, confession and
jpenance should — and in many instances rather clearly do
! — ^have a genuinely hygienic effect, limitations in the
|Catholic system notwithstanding. And among those who.
Within the Church, emphasize this aspect of the practice,
inone is more urgent and eloquent than Father Alfred
fWilson, C. P., in his book Pardon and Peace (1954).
IWorthy of close study in its entirety, this work (''Nihil
'obstaf') can here be considered only in the most cursory
fashion. But the author, having paid his respects to the
sacramental aspect of confession, comes quickly and
'clearly to his central thesis, which is that confession is
unmistakably and powerfully therapeutic. He says:

202 The Crisis in Psychiatry and Religion

Our unfortunate non-Catholic brethren do not know what
they are missing, and little realize the blessings that heresy
has snatched from them (p. 2).

No one goes to the doctor or the dentist for fun, unless
he is mad. No one goes to Confession for fun. From the na-
ture of the case, confession cannot be easy. The result, not
the process, of confession is consoling.

After serious sin, however, we have no alternative but to
confess if we desire to regain undisturbed peace of mind
and safeguard our sanity. We must lift the burden from our
minds, or become a burden to ourselves and risk becoming
a burden to others. Confession is then — if you like to put
it that way — the lesser of two evils (p. 3).

Why is this relief necessary? Why must we tell our misery
to at least one representative of the human race? Because
until we confess we feel hypocrites. We feel that we are
being taken for a hundred percent good and we know we
are not. We feel that we are obtaining respect and love un-
der false pretences. If, however, we can find one member
of the human race who will listen to us sympathetically, who
can know the worst and still respect and love us, we feel that
our self-respect and social status are somehow restored. We
can then reasonably hope for the respect of our fellow-men,
despite our fault.

Sin sets up in the mind a conflict between our self-respect
and our social sense. That conflict can be terminated only
by some form of confession. "Confess, therefore, your sins
one to another that you may be healed" (p. 5).

There then follow some well-chosen phrases especially
meant for Protestant ears:

Confession is the only remedy. It is no use to say, as many
non-Catholics do: *'I confess my sins directly to God, and
that is quite good enough for me." First of all, it is the
common experience that confession to God alone does not
bring the fullest measure of relief of mind. It is no argument
against this to say that it is not your experience. It is the
common experience, and it is safe to presume that Christ
legislated for the rule and not the exception.

In any case, adequate mental readjustment after sin re-
quires readjustment of our relations with our fellow-men as
well as with God. If you insult a friend, it is not enough to
apologize to God — ^you must apologize to your friend as well.
. . . Sin is an offense against society as well as against God,
and for both offenses adequate reparation must be made. . . .

All these unrealists (who pout incessantly and suspiciously

Protestantism: ii. Challenge and Change 203

about their realism) are heading for a nervous breakdown
(p. 6).

And then, again in a more general vein, Father Wilson
continues:

Confession of serious sin is necessary for the restoration
of health of mind and soul, redundantly, even for health
of body. "Suppressed sin, like suppressed steam, is dangerous.
Confession is the safety-valve" (Weatherhead, 1929, p. 88).

Modern psychologists have rediscovered this. They have
found from practical experience that many nervous break-
downs can be traced to a sense of guilt from unconfided and
unforgiven sins (p. 8).

I don't think the majority of Catholics realize how much
they owe to the Sacrament of Penance. One of the greatest
of Viennese psychologists, a man bitterly anti-Catholic [pre-
sumably Freud], had the honesty to admit that, among his
cases of serious psychological disorder, he had never had
a genuinely practising Catholic (p. 10).

Now, in stark contrast, we turn to a recent article by
father Richard P. Vaughn, S. J., entitled "Mental Illness
mong Religious." Here the whole emphasis of the Wil-
on book upon the relationship between unredeemed sin
nd emotional disturbance is flatly repudiated:

In spite of research data to the contrary, there still persists
a vague suspicion that mental illness is in some way con-
nected with a sinful life or at least that it cannot occur if a
person is leading a truly holy life.

A psychosis is a type of sickness, just as are ulcers of the
stomach or cirrhosis of the liver. Whether the cause of the
psychotic condition is psychological or organic or a combina-
tion of both (which is more likely) has not yet been estab-
lished. It can, however, safely be stated that a psychosis
(with the exception, perhaps, of a condition brought on by
alcoholism or drug addiction) is not the result of a sinful
life. The idea that it is the effect of sin is simply a remnant
of past attitudes which still prevail from an era when little
was known about psychiatry and psychology. The fact, there-
fore, that a religious person becomes psychotic does not in
any way imply past moral indiscretions. Religious,'' even
though they follow a more perfect way of hfe, are no more

' "Religous" is the Catholic term for persons who have taken
loly Orders.

204 The Crisis in Psychiatry and Religion

immune from severe mental illness than the average lay per-
son (pp. 27-28).

What a remarkable exhibit! Despite the ancient and
widespread folk belief that there is a connection between
moral integrity and psychological integration, and despite
the obvious advantage which accrues to Catholicism if it
can be successfully maintained that confession is mentally
hygienic (as well as sacramental), here is a Jesuit se-
riously and insistently arguing against this position. The
reason for his discomfiture is, however, not far to seek:
it is impossible to verify the effectiveness or ineffective-
ness of confession as a sacrament, and the Church can
continue to make great metaphysical claims for it without
fear of empirical refutation; but as soon as one makes a
claim for confession as an instrument of either preven-
tion or treatment, such a claim immediately becomes
susceptible to empirical check — and it is already known
that the facts on this score are somewhat ambiguous.
Wilson, as we have seen, implies that confession, as pre-
scribed by and practiced within the Church, is virtually
a panacea as far as emotional and psychological disturb-
ances are concerned; whereas Vaughn is equally emphatic
and categorical in holding that there is no connection here
at all! The truth probably lies somewhere in between; but
with its doctrine of infallibility, the Church must, of
course, take an all-or-none position — partially effective
measures not being admissible. Yet, as it functions today,
confession apparently has precisely this status, psychologi-
cally speaking: although it is or, at least under the most
favorable conditions, can be a decided aid to mental
health, the mere formal observance of the rules govern-
ing confession is no guarantee thereof; and the Church,
some v^iters apparently feel, cannot afford to lay claim
to any power which is not absolute.

The situation is further illuminated if we note that in
writing for and about religious laymen, as Father Wilson
obviously did, it can always be argued that if a Catholic
encounters intractable emotional difficulties, this is be-
cause he has in some vital respect failed as a Catholic —
and I am personally persuaded that there is some merit in
this argument. But once a man or woman has taken Holy
OrderSf the situation, per theory at least, is importantly

Protestantism: ii. Challenge and Change 205

modified. Here are the best, "the religious/* an elite
guard, in whom human frailties have been all but van-
quished; and the fact, indeed prevalencey of serious men-
tal disorder among monastics (especially women) is well
established (cf. Moore, 1936) . This problem is, indeed, so
serious that Father Vaughn pleads for ''psychological
screening" of individuals entering the orders:

Many a community has spent thousands of dollars for the
hospitalization of a single psychotic member, and this at con-
siderable sacrifice to the other members of the community.
And then after all this expense, it not infrequently happens
that the religious is finally diagnosed as incurable. In such
cases one might well ask whether such a diagnosis would
have been reached if the psychotic religious had never been
subjected to the strain and disillusionment of the religious
life (p. 29).

Here is an oblique admission that at least for those
entering the special orders, Catholicism, far from being
therapeutic, may have exactly the opposite influence. It
is little wonder, therefore, that this whole matter is at
present a very painful and confusing one for the Church,
from top to bottom. The ambiguity of the situation is, in
fact, excellently portrayed by a current article on "Sin,
Sickness, and Psychiatry," by John R. Connery, S. J.,
which appears in America, the official Jesuit journal of
opinion and controversy. Here the author says, by way of
introduction :

The various aspects of this conflict are best illustrated in
the different opinions advanced regarding the relationship
between sin and mental sickness. Besides the opinion that
would regard sin as sickness rather than an expression of the
will of the sinner, there is a second opinion that, surprisingly,
reverses the relationship. According to this opinion, sin, far
from being the result, is really the cause of mental illness. A
third opinion refuses to consider sin either as cause or effect
of mental illness, but tends to regard it as the cure (p. 493).

It is, of course, not surprising that the author of this
article should reject the first and third of these hy-
potheses. The Church, obviously, cannot concede either
that sin is an expression of psychopathology or that it is
a cure thereof ["Have an affair!" "Act single!" cf.]. It
is, of course, the second possibility, namely that uncon-

206 The Crisis in Psychiatry and Religion

fessed and unexpiated sin is the cause of psychopathology
that gives Cathohc theorists the difficulty. Connery ad-
mits that:

It is quite true that the act of confessing one's sins, the
acceptance of the priest and of his pastoral counsel can
have some therapeutic value, but this is not the primary pur-
pose for which the sacrament was instituted. The sacrament
of penance is primarily a sacrament of forgiveness (p. 493).

Then the author tries to come more specifically to grips
with the hypothesis that "neurosis must be traced to
sin." He says:

According to this opinion, it is because the patient has
repressed his conscience, rather than because he has repressed
his instinctive drives, that he develops a neurosis. Although
this position is held by some first-rate psychologists and psy-
chiatrists, it is vigorously opposed by equally competent repre-
sentatives of these fields. From a religious viewpoint it does
not have the objectionable features of the opinions already
considered, but it is not necessarily true because it is reli-
giously more agreeable. There are, indeed, good reasons for
questioning it. First of all, there are many habitual sinners
who to all appearances have average mental and emotional
balance. Secondly, the scrupulous conscience, which usually
must be classified as neurotic to some degree, does not ordi-
narily have its origin in past sin. For the most part, the scru-
pulous individual is as remote from sin as one can get (p.
495).

This is an incompetent and irresponsible statement.
The argument that, because all persons w^ho are sinners
are not mentally disturbed, there is no relation at all be-
tween sin and insanity is a classical non sequitur which
I have discussed elsewhere [Chapter 1 3] . And in the same
connection I have cited evidence (as well as another
Catholic authority— Stafford, 1950) for the view that
scrupulosity is a neurosis precisely because the individual
so afflicted prefers this symptom to an honest and thor-
oughgoing confession.

No, the plain truth is that most Catholic writers do
not wish to recognize neurosis as a basically moral and
social problem, because they realize that to do so raises
embarrassing questions concerning the adequacy of
Catholic doctrine and practice, thus underscoring the

Protestantism: ii. Challenge and Change 207

specific limitations and criticisms which I have enumer-
ated in Section IV. Here, therefore, is a wonderful op-
portunity and challenge to other religious groups: to
develop ways of dealing with personal guilt which are
genuinely adequate, psychologically and ethically, and
which do not retreat into the realm of metaphysical
claims which defy verification. It is also an opportunity
for Catholicism to take stock of itself and institute some
long overdue reforms.

A curious but not uninstructive drawing accompanies
the article by Father Connery, which is also reproduced
here. What does it mean? I hold it expresses the am-
biguity, the confusion, the sickness of the contemporary
Catholic position in this whole matter of sin and psy-
choneuroses. The figure, ostensibly a monk, is caught in

208 The Crisis in Psychiatry and Religion

a posture which is both rehgious and schizophrenic. The
Church, which has a conscience, is sore afflicted because
it is refusing to minister to anxious, depressed people for
fear of compromising or having to modify its doctrinal
pretensions. If the Church is so rigid and fixated that it
cannot act as a physician to itself, the necessary accom-
modations and changes must be made, as before, outside
the Church.

Vn. STRAWS IN THE WIND: A CASE HISTORY

With issues as global and controversial as those with
which we have dealt in these two lectures, it is easy to
doubt, at times, the validity of one's most basic assump-
tions. There is no simple, direct way of testing or demon-
strating them — to others or, indeed, to oneself; and when
they represent a marked departure from ordinary beliefs,
one wonders, occasionally, if they may not be sheer
fantasy. There is, however, a stark reality to which I
return in my doubting and always find grimly reassuring.
In an era in which physical disease has been spectacularly
reduced, the indices of personality disorder, by contrast,
have steadily risen. In the two decades between 1934
and 1954, the death rate in this country declined 13.6%
(Fagley, 1960, p. 29); but during this same period the
likelihood of one's spending some part of his life in a
mental hospital — the abode of the ^'living dead" — rose
from about one in 20 to one in 10. The evidence that
prevailing views and practices in this area are seriously
inadequate is thus compelling. And at least small signs
keep emerging which point in the direction of alternatives
which seem more promising.

Following a lecture which I gave a few months ago in
a city in Northern California, a diffident but obviously
intelligent middle-aged woman approached me and said
that she thought I might like to know that the Church
of the Latter Day Saints has always placed a great deal
of emphasis upon good deeds — in contrast to the Pauline
doctrine of justification by faith — and, as a result, has
been a constant target for criticism by Protestant the-
ologians. This bit of information did indeed interest me;
and somewhat later I happened to mention it to a social
worker who, himself a Mormon, volunteered the addi-

Protestantism: ii. Challenge and Change 209

tional information that his rehgion sets aside one Sunday
each month for open confession. Then he mentioned a
case history recently reported to him by a non-Mormon
chnical psychologist known to both of us which indicates
the possible therapeutic effectiveness of the Mormon ap-
proach in these matters. I immediately wrote for further
details; and the psychologist obligingly supplied a copy
of the "Social Service Intake" record and of his own
"Termination Note." The first of these documents reads
as follows:

This 21 -year-old female is referred by Dr. because

of anxiety over sexual adjustment, brought about by long-
standing unsatisfactory sexual relationships with her father.
She is a rather large, plump girl who brings a long tale of se-
duction and mistreatment by her father since approximately
age 7. She is not a particularly verbal girl, and did not volun-
teer much during the interview. She has been going with a boy
for approximately six months, has thought of marriage, but
is physically repelled by him. She states that sex is associated
in her mind with sin and pain, and that she would like help
to relieve these feelings. Her conversation was flat and unemo-
tional throughout the interview, and she has a rather placid,
unemotional face.

Patient is the oldest of four children, having a full sister,
a half sister, and a half brother. The patient's mother died
when she was four years of age and the father remarried

about four years later. is a daughter by the stepmother's

first marriage, and is a son by the present mother and

father.

The patient states that the father has forced sexual rela-
tionships on her and her two sisters since the patient was 7
years of age, that he has been extremely abusive toward her,
that he has never shown any affection except when sexually
aroused, and that she has come to think of men as being
brutal persons who want nothing but physical satisfaction
from their women. She was particularly irked by the fact
that her father played favorites, and was frequently quite
seductive toward her sisters in her presence. She has tried to
work out her problems with her boy friend's help, but feels
intensely frigid toward him when he becomes affectionate.
I Her general attitude toward sex has been that it is dirty, and
j it has been with effort that she has associated with boys,
usually preferring and feeling more comfortable with girls as
friends.

Currently, the father is at Psychopathic Hospital

undergoing psychiatric evaluation, since the girls filed a com-

210 The Crisis in Psychiatry and Religion

plaint with the County Insane Commission.* The patient
reports that he has been increasingly abusive, suspicious,
jealous, and demanding of his daughters. Matters reached a
head this spring when the patient returned from her third i
year of college and refused her father's advances. Currently,]
the stepmother is attempting to defend him legally. Thej
patient's impression is that the stepmother has known about j
these affairs for many years, but that she has not wanted'
to do anything about them. i

IMPRESSIONS AND RECOMMENDATIONS: This girl Certainly'
has problems connected with a long-term unsatisfactory rela-
tionship with her father. It is understandable that she
should equate sex with brutality, and that there should be a
distortion in her relationship with men. Significantly, she
suspects men of seductive motivations to the extent that she
expressed a fear that I might attempt to "seduce" her. It
had not occurred to her that such a possibility in a setting
like this would be totally unrealistic. There is a question in
my mind in regard to her motivation for therapy, but this
impression may be imposed by her rather flat manner and
affects. The patient should be seen for psychiatric evaluation,
and should probably be scheduled for full psychological ex-
amination at an early date. This does not appear to be an
emergency case, and could be placed on our waiting list
following the diagnostic studies.

Executive Director

* The father was given a long prison sentence subsequent to
this evaluation.

This case has many interesting implications and is
especially pertinent to the present discussion. It is clear
that this young woman's guilt concerning the incest
was a barrier to normal marriage and that her coming to
the clinic was prompted by the fact that she had become
of marriageable age and had some prospects. She felt —
quite understandably — that she could not get married
with the incest on her conscience; and she was forthright
in saying that she * 'would like help to relieve these feel-
ings."

The intake worker reports that the client — ^let us call
her Marie — "has come to think of men as being brutal
persons who want nothing but physical satisfaction from
their women," thus implicitly shifting blame and partially
rationalizing her own conduct^and somewhat becloud-

Protestantism: ii. Challenge and Change 211

ing the reason why she can't get married. But if there
were not deep guilt and self-rejection in the situation,
it seems that the early introduction to sex and prolonged
experience with it would have paved the way for con-
tinuation with others. Instead, *'sex is associated in her
mind with sin and pain." Also it is noteworthy that
Marie, while intimating that the stepmother knew of the
incest, gives no indication of ever having appealed to
her for help. If there had been no complicity in the
situation, it seems there would have been a complaint
or protest, to someone!

On another occasion [Chapter 8], I have discussed
the deep incest guilt of a schizoid girl known as Joan.
But in situations where frank psychopathology is present,
a skeptic can always dismiss the incest — and, therefore,
real guilt as the cause of the "illness" — as a fabrication
or "delusion" or can interpret the act, if real, as an early
expression of the disease itself. (In fact, the counselor
who initially reported the Joan case, anonymously, has
recently written to me and expressed — apparently for
theoretical rather than empirical reasons — some doubt of
the validity of Joan's report of the experiences with her
father. ) But in the present situation, there is no question
of "schizophrenia" or any other well developed mental
disease; and the fact of the incest seems established
beyond doubt (cf. the prison term given to the father
for the offense). Hence, the "dynamics" of the case seem
particularly clear, unambiguous, and instructive.

Let us now examine the "Termination Note" dictated
and generously provided by the psychologist to whom
Marie was assigned:

Marie was referred by Dr. in September, 1957, be-
cause of extreme fears regarding sexual relations, in part
stemming from long-term incestuous relations with her father.
She was seen for a total of 12 interviews (primarily psy-
chotherapeutically) from November 31, 1957, to April 19,
1958. Marie is being terminated since she will be leaving for

to obtain work and probably resume College after a

while.

Marie had a very strong fear of the close relationship with
a man in psychotherapy which resulted in her extreme tension
with me at the beginning of the treatment process, wanting
to quit treatment several times, and finding different excuses
not to make regularly scheduled appointments. At first my

212 The Crisis in Psychiatry and Religion

interest in her was interpreted by her as having sexual imphca-
tions. Slow and careful work with her resulted in excellent
progress for the relatively few short interviews considering
the nature of her problem. Marie has begun to show greater
initiative and less extreme submissiveness; there was a definite
decrease in her extreme feelings of being "so different and
so inadequate," now she can allow herself to try many things,
whereas before she would have been convinced prior to any
attempt that she could not accomplish the task. There was
the beginning of a greater feeling of being at ease with all
people including men, plus less sinful and guilty feelings re-
garding sex. She was able to lose weight more quickly than
ever before in her life, probably a reflection of her decrease
in fear of being attractive to men.

However, though the progress was excellent, it is felt that
much more psychotherapy need be undertaken prior to her
ability to deeply enjoy a close relationship with a man, such
as in marriage. We had just begun to directly work on the
very disturbing sexual area when Marie got this fine oppor-
tunity to go to and live with persons whom she felt at

home with in her new-found religion, that of the Latter-Day
Saints.

Her definite need for further treatment when she gets to

appeared to be fairly well emotionally accepted by

Marie. Perhaps more than any insight, the one thing that
was most helpful to her was the beginning of the develop-
ment of some deep trust in one man. However, whoever
works with her in psychotherapy should anticipate a pretty
stormy relationship with her, including such things as want-
ing to terminate treatment many times, and finding excuses
for not coming to interiews.
TYPE OF service: Diaguosis and treatment.
CONDITION ON TERMINATION: Improved.
diagnosis: Phobic reaction (intense fear of close relationship
with all men) in a passive-aggressive personality, passive-
dependent type.
disposition: Patient withdrew from Clinic service. Clinic

notified, (moved)
prognosis: Good for continuation of above described gains;
need for further psychotherapy after she moves.

, Ph.D.

Chief Psychologist

The orientation of the staff of the clinic to which
Marie resorted for help was rather clearly Freudian; and
we may conjecture that in therapy an attempt was made
to get her to feel that not all men were like her father

Protestantism: ii. Challenge and Change 213

md that she therefore had no justified reason to fear
them — and sexual relations. But if we assume, as we rea-
ionably may, that Marie's problem was not simply one of
traumatic conditioning against sex but rather an incon-
testable personal guilt, then her *'fear of men" (as author-
ity figures) was justified, in a very different way; and sens-
ing that the therapy was not addressed precisely to her
[leed, it is perhaps not surprising that Marie was restive,
dissatisfied, and eventually "withdrew." A letter from the
:herapist, which accompanied the materials already
presented, is particularly illuminating. It reads, in part, as
Follows:

I am happy to share with you some details of the case of
a young womaiTwith whom I worked and for whom the
membership in the Mormon Church seemed to be a con-
structive change. . . . This young woman had been a mem-
ber of a fundamentalist Protestant church, in which she ap-
parently frequently felt terribly guilty when she was present
at their services. I have the feeling that therapy may have
helped her to reduce enough of the neurotic guilt so that
she was able to seek out a religion, which was guilt reducing,
paternalistic and supportive, the Mormon religion. Then
perhaps the Mormon religion in turn is helping her to reduce
the neurotic guilt and thus handle normal guilt, and life in
general, more constructively.

It is not clear why reference is made here to "neurotic"
^uilt. Surely the assumption is not that this young woman
should have emerged from her situation with no guilt,
or that the guilt she felt was unjustified or dispropor-
tionate. The circumstances were, to be sure, somewhat
Extenuating; and it is much to the girl's credit that she
Eventually took it upon herself to do what she could to
rectify matters. But it is hard to see how anyone with
Even a semblance of character and social awareness could
have gone through what this girl had and be more normal
or symptom-free. Here, if it was ever the case, guilt was
a facty a tragic and inescapable reality, and not just a
"neurotic" feeling. And it is no accident, surely, that
secular therapy was characterized by the girl's "wanting
to terminate treatment many times, and finding excuses
for not coming to the interviews." We can hardly escape
the inference that she sensed her problem was not
understood and that no real help would be forthcoming.

214 The Crisis in Psychiatry and Religion

Here we also have an excellent example of the com-
mon failure of Protestant churches to cope with desperate
personal guilt on the part of its members. There is no
indication that this girl went to her minister about her
problem at all; and if she had, the chances are he would
either have been horrified and made a quite nonfunc-
tional scene of some sort or, if more considerate, would
have immediately admonished the girl to ''seek God's
forgiveness in prayer." If, on the other hand, the church
had been liberal (rather than Fundamentalist), the
minister might have tried to be more enlightened and
to "counsel" with her along essentially secular lines,
with a reaction similar to the one she gave to the therapy
she received at the clinic.

The moral of this case is, therefore, clear: it indicates
that neither Protestant theology nor Freudian psychology
is at all adequate to the needs of deeply guilty people
and that we must instead seek and utilize the healing
power of human community and good deeds, rather than
ignore and despise them.

VIII. confession, community, and character

In February, 1960, I spent a few days on the campus
of the State College at Corvallis, Oregon, and while
there Professor Lester A. Kirkendall told me of the fol-
lowing observation. Professor Kirkendall has done a great
deal of counseling with college students, particularly
with young men; and over the years he says he has found
a striking correlation between a student's general social
adjustment and the degree of normality in his sex life.
If the man has good social relations, the chances are
very high that he will report no serious conflict, perver-
sion, or the like in the sexual realm. But if there is
seclusiveness and uneasiness with people, there is likely
to be some anomaly in the matter of sex.

Intuitively this relationship is not surprising, but it
is useful to look at it somewhat more analytically. If
there is perversity or evil in a man's sexual practices, it
stands to reason that he should be socially ill at ease:
if he has any character at all, he will, as a matter of
course, feel guilty and will be uncomfortable in the
presence of others. But this perception of the situation,

Protestantism: ii. Challenge and Change 215

valid as it probably is, leaves unanswered the question
of why some young men are sexually normal, others
perverse and deviant. Dr. Kirkendall is inclined to believe,
and I certainly share his impression, that good control
in the matter of sex is most likely to be achieved in an
individual who, as a matter of policy and habit, is
socially open, has a strong sense of community, and
shuns secrecy and duplicity.

We are likely to think of strength of character and
so-called will power as something we have or exercise
deep down inside us. And we are likely to try to improve
this capacity in others by admonishing, scolding, lectur-
ing them. I am increasingly persuaded that will power
or self-control is not nearly so much of an individual
matter as we sometimes think. Instead, is it not basically
a social phenomenon? Here, in society, is where the
norms and values reside, and the person whose life is
open to social interaction and influence has the benefit
of social supports and sanctions. But the individual who
embarks upon a policy of covertness and secrecy does not
have this source of strength and soon finds himself the
victim of uncontrollable temptation and, as he is likely
to experience it, a "weak will." Superficially, the diffi-
culty lies in the area of his sexual drives and practices;
but more fundamentally the problem is one of . social
integration or the lack of it.

The pertinence of confession and community here is
obvious. A few years ago I was discussing this general
problem in a summer-school class, and a student spoke
up and said that some of the banks in Chicago regularly
give their employees lie detection tests. Not immediately
seeing the point of this comment, I must have looked
a trifle puzzled, so the student added: "It helps them
stay honest." I then realized that the purpose of this
procedure is not so much to detect anyone who has
already done something wrong; rather it is to create a
feeling that if anyone begins a dishonest practice, it will
soon be known. This amounts, in effect, to periodic
"confession." And if one knows that whatever he does
is going to be known, one usually finds that he has the
"will power" not to do it. Often we think of confession
solely as a mechanism for relieving us of guilt associated
with acts already committed. If confession is not made

216 The Crisis in Psychiatry and Religion

artificially easy, I am persuaded it has not only this
redemptive function but also a strongly prophylactic one
as well.

Sin, as Bonhoeffer aptly observes, demands to have
a man alone. As long as as a man is in community, in
free and open touch with others, he will have a vivid
sense of the consequences of wrong acts which gives him
the strength, and wisdom, not to commit them — or, if
he does, to move rapidly toward their rectification. But
if he has committed himself to the path of hypocrisy, of
being with people but not of them, he does not have
this advantage and is almost certain to get into moral
predicaments of one kind or another.

The great Protestant emphasis has been, of course,
not upon the relation of man to man but on the relation
of man to God. By-pass human intermediaries and take
our sins and concerns directly to God in prayer, that has
been the sovereign Protestant strategy. For the morally
and religiously well-developed person, I am sure this is
often sufficient. The man of character so prizes a clear
conscience and free communion with that immanent or
transcendent something called God that he is extremely
careful of his conduct, without any necessary reference
to whether it will or will not be known to others. But
this is the end, not the means, of a long developmental
process. In children openness and integrity have to be
taught and experienced first in the context of the family;
and when, in an adult, there is an inadequacy or failure
of character, personal reconstruction seems far more
likely to occur in the horizontal than in the purely
vertical dimension.

What is the place of ordinary church attendance and
public worship in the lives of men and women? Again,
for the religiously and morally mature and the emo-
tionally healthy, I have no doubt that corporate confes-
sion is helpful and ordinarily sufficient. But in extraor-
dinary circumstances, it is often seriously inadequate
and urgently needs to be supplemented by procedures
which are generally lacking in the typical Protestant
church.

One of the great problems of our time is said to be
that the average man doesn't "know who he is." This
is a sign of neuroticism. Feelings of depersonalization and

Protestantism: ii. Challenge and Change 217

a sense of unreality are typical of the experience of
severely disturbed persons. How else would we expect
it to be? If our thesis be correct, the essence of psycho-
pathology is systematic denial of who one is; and if we
misrepresent ourselves to others, it is not surprising that
we soon begin to appear alien, strange, and ''unfamiliar"
even to ourselves. Francis Thompson ends the first stanza
of his great religious poem The Hound of Heaven with
the trenchant thought, "All things betray thee who
betrayest me." We cannot, it seems, escape the fact that
we can be true to ourselves only if we are first true to
others. At a very profound level, Shakespeare was right,
of course, when he said that if we are true to ourselves
we cannot be false to any man. That is to say, one's
own long-term self-interest is consistent with his social
interest. But in ordinary day-to-day practice, we are
undoubtedly on sounder ground if we seek to find our-
selves in the life of the group than if we attempt to
fashion the group according to our own image and
designs.

IX. CONCLUDING COMMENTS
AND RECOMMENDATIONS

Increasingly it appears that the central fact in per-
sonality disorder is real guilt and that it can be radically
resolved only by confession that has at least a quasi-public
character. But, as we have seen [cf. Chapters 4, 5, 8,
and 13], this always involves, at least in well developed
personalities, the danger of a catastrophic reaction, which
may take the form of psychosis, suicide, or other forms
of ''acting-out." Assurance of God's love, grace, and
forgiveness are to no avail in such a crisis. What, then,
should clergymen do in the face of an eventuality of this
kind? Here I have only tentative suggestions to offer;
but I am convinced that sound and effective measures
can and will be found if religious leaders and dedicated
laymen take seriously the moral basis of personality dis-
turbance and allow themselves to feel the full force of
the responsibility which thus logically devolves upon
them. My suggestions, listed more or less randomly, are
these:

1. Clergymen and pastoral counselors need to have at

218 The Crisis in Psychiatry and Religion

their disposal facilities for providing continuous care and
supervision for persons during periods of acute disturb-
ance. If the acute stages of a personality crisis can be
handled in this way, more protracted institutionalization
can, I believe, often be avoided. I know a church in
Philadelphia which is in the process of establishing such
a facility, to be staffed, as occasion requires, by regular
church members, its ministers, and Christian physicians.

2. A special effort should be made to elicit the interest
and assistance of persons who have themselves had per-
sonality disturbances and have made a good recovery
therefrom. They are likely to have less fear of other
disturbed individuals than does the ordinary person; and
they often also have deep insights and are highly mo-
tivated. Care of and concern for others is powerfully
therapeutic in its own right.

3. Ministers need to band together in their community
for a sort of "group practice." In this way the individual
counselor can be made both more cautious and more
courageous, with group consultation and supervision
available to him. A project in Kokomo, Indiana, which
has been inaugurated by Granger Westberg, with sup-
port from the Lilly Endowment, offers a model for this
type of development.

4. Ministers with specialized training and experience
in counseling can be of great assistance in guiding,
teaching, and supporting other ministers in their efforts
in this area. Russell Dicks has recently established him-
self, in a community in Florida, in a unique kind of
"private practice." His plan is to accept referrals from
other ministers and to deal with them, on a fee basis,
while at the same time encouraging the ministers making
the referrals to follow developments and thereby extend
and improve their own competence. Such a procedure,
if widely adopted, is almost certain to evoke a protest
from the psychiatric profession (see Joint Committee
on Relations between Psychology and Psychiatry, 1960).
But if its effectiveness can be demonstrated, social and
legal protection will follow.

5. Young Protestant clergymen with whom I have
recently talked complain of their "lack of authority" in
dealing with problem persons. They lack, they say, the
sanctions of both priest and physician and feel quite

Protestantism: ii. Challenge and Change 219

helpless in asserting any kind of decisive influence upon
others in time of crisis. My conviction is that as their
competence and confidence in this area grow, ministers
will find that so also have "authority." Clinical psychol-
ogists, in a somewhat similar predicament, have found
that making continued psychotherapeutic contact con-
tingent is often effective in inducing client compliance.

6. The individual undergoing acute personal crisis
needs to see the potentially constructive, growth-inducing
potentialities of the experience. Here the writings of
Anton T. Boisen can be particularly helpful. I believe
in encouraging the disturbed person to see his situation
as involving what Old Testament writers referred to as
the Wrath of God. At the same time it should be pointed
out that the Wrath of God is the form in which those
who defy Hirn experience His Love. The chastisement
of an unruly child by loving parents is a meaningful
analogy.

7. While accepting the self-condemning and self-pun-
ishing tendencies of the "sick" individual as under-
standable, reasonable, and even right in a certain sense,
an effort should be made to help him move as rapidly
as possible from expiation to restitution, from self-lacera-
tion to a program of service, self-discipline, and meaning-
ful sacrifice. In my judgment the reason electroshock
convulsions are often "therapeutic" (especially in depres-
sions) is that they aid and expedite the work of self-
punishment. In the preceding lecture we have alluded
to the extent to which charity has become secularized
and, in a sense, even commercialized (as "insurance" of
various kinds). In Zborowski and Herzog's recent book.
Life Is with People, an interesting picture is given of
traditional Jewish life in the now all but vanished "stetl"
villages of Eastern Europe. There philanthropy was con-
tinuously practiced, by almost everybody, as an everyday
aspect of ongoing social and religious life. Many of the
traditional occasions for generosity have, of course, dis-
appeared in modern society; but there are always impor-
tant and deserving "causes" to which one can contribute
time and money. It is thus not so much the opportunity
for generosity which has disappeared as the logical and
psychological rationale therefor. The latter desperately
needs to be recovered.

220 The Crisis in Psychiatry and Religion

8. The Apostle Paul has warned against attempted
"justification" through good works, "lest any man should
boast." Then let us not "boast" but rather make restitu-
tion and perform good deeds without publicity and self-
acclaim. Attempts to pray, analyze, or tranquilize our-
selves out of sin have been ineffective. A more active
form of "therapy" seems our only remaining option.

Somewhat parenthetically I want to say that I am not
unaware that the approach here proposed is at least super-
ficially paradoxical: it might be characterized as a sort
of irreligious religious approach to the problem of per-
sonality disturbance. More accurately, one might say
that the approach is actively religious but minimally
theological in the conventional sense of that term. The
approach is religious in the sense that it accepts the
reality of unconfessed and unredeemed sin as central in
psychopathology and holds confession and restitution to
be commonly necessary for recovery. But it involves a
minimal theological emphasis in that it stresses the
interpersonal dimension as more crucial for therapeutic
movement than the man-God relationship because it is
the former that has been most palpably ruptured and can
be repaired, in many instances, only by the individual's
working hard at modifying and improving his everyday
conduct.

Some years ago I heard a Park Avenue minister, in
New York, take the position that if man's relation with
God goes wrong, he is soon in trouble with his fellow
men, and that when this happens he is automatically in
trouble with himself; so, by implication, the place to
start "therapy" or redemption is in the vertical, man-
God dimension. Empirically, this assumption does not
seem to be well borne out. And the psychoanalytic as-
sumption that we have to work on our relationship with
ourselves has also been a disappointment. The possibility
that remains is the interpersonal approach, and it is the
one which is now attracting most interest from secular
students of the problem. It is also the one which holds
greatest promise of a genuine rapprochement between
science and religion in this area. Dr. Gordon McKay,
President of McCormick Theological Seminary, has a
talk which he sometimes gives to ministers entitled,
"Don't Pray Too Soon." I have not personally heard this

Protestantism: ii. Challenge and Change 221

talk, but Dr. McKay has recently written concerning it
as follows:

The general notion behind the talk is that prayer is too
frequently employed as a substitute for action. Beyond that^
the resort to prayer is frequently among ministers little more
than a cover-up for their ignorance and/or unwillingness to
employ such community recourses as are available to serve
the needs of men and women whose lives are blighted by
such problems as alcoholism, marital discord, and mental
illness.

It seems to me that a full understanding of the Pauline
concept of salvation requires us to recall that Paul's strong
insistence on justification by faith was always coupled with
the admonition that we are to work out our salvation with
fear and trembling. Every great theological discourse in Paul's
writings is followed by a chapter or two on moral teaching.

And recently I heard Dr. Roy Burkhart, of the First
Community Church in Columbus, Ohio, say that salva-
tion is a social operation. Certainly there is a growing
disposition on the part of sensitive and perceptive clergy-
men to emphasize this approach. It is, I believe, ex-
tremely promising; and if metaphysical assumptions can
be, at least for the time being, held in abeyance and a
renewed emphasis put upon the interpersonal dimension,
[ believe something of a "break-through" can be achieved.

13

Footnotes to a Theory
of Psychopathology"^

As the title indicates, this chapter repersents an attempt
to pick up loose ends of fact and logic and tie them into
the general argument with which this book is concerned.
Here we see, again, the internal weaknesses of psycho-
analysis, both as formal structure and as a^' system of
practice, and the ambiguity of a theology which finds it
congenial.

Not long ago, in talking with a Lutheran minister,
I remarked of a certain church practice that it might be
theologically necessary and sufficient but that it was
manifestly not psychologically adequate. To which my
friend replied: ''In my opinion, if a practice is not psy-
chologically adequate, it's not theologically adequate!"
Here, surely, is a fine spirit, which can go far toward
forging the new, unified conception of man in which we
today stand in such need. But in this chapter we see,
with special clarity, that before a valid synthesis of this
kind can come about, we must have both a psychology
and a theology which are in certain important respects
different from what we have recently known. In other
words, our explorations, here and in other chapters of
this book, suggest reform in contemporary theology as^
well as in psychiatry and clinical psychology.

1

In a series of recent papers [Chapters 2, 8, and 9],
I have dehneated that conception of personahty dis-
order which seems to me logically most compelling, em-
pirically best supported, and therefore most promising
in terms of new and more radically effective methods of
personal (and social) reconstruction. Here it will be

* Presented April 20, 1960, before the Los Angeles Society of
Neurology and Psychiatry and independently published in
Progress in Clinical Psychology (D. Biower & L. E. Abt, edi-
tors), Grune & Stratton, 1960.

222 i

\ Theory of Psychopathology 223

leither possible nor necessary to restate that conception
n any comprehensive way. Instead, the present paper
vill take for granted a general familiarity with this
:heoretical framework and will advance some additional
considerations in the nature of footnotes or marginal
ottings and comment.

:. CHANGING PERSPECTIVES

Viewed in retrospect, how truly remarkable was that
conception of psychopathology which dominated theory
md practice two or three decades ago! Genuine guilt,
ustified self-loathing, and realistic interpersonal uneasi-
less were given little or no weight in the genesis of the
o-called psychoneuroses, where false conscientiousness
vas assumed to be capable of playing veritable havoc,
n other words, a supposedly overly severe superego,
temming from unduly strict childhood training and
otally unsupported by ongoing experience and social
)r legal realities, was assumed to be more powerful and
herefore more likely to disturb or destroy our peace of
nind than was a sound, realistic, normal conscience
vhich the individual had outraged by engaging in palpa-
)le, unacknowledged, and unredeemed misconduct. Such
I thesis is clearly contrary to common sense and what we
enow about the principles of reinforcement and extinc-
:ion (in learning theory) and is controverted by all sorts
)f clinical evidence; yet it was seized upon and pro-
laimed as a great scientific discovery and cultural achieve-
nent.

Now, within the last five or ten years, the picture
las changed considerably. No longer is it maintained
:hat the Freudian doctrine is universally applicable but
)nly, perhaps, in some cases. For example, Jourard
[1958) interprets the present situation as follows:

Clinical experience suggests that neither Freud nor Mowrer
is wholly correct or wholly incorrect. Rather, it can be found
that some neurotic patients do indeed have a conscience
that is too strict; in order to remain guilt-free, they must
refrain from all pleasurable activities, including those which
society condones. Other patients may be found with the
makeup which Mowrer has regarded as nuclear to all neurosis

224 The Crisis in Psychiatry and Religion

— they repress conscience so they can break social taboos
without conscious guilt (p. 366).

This is not necessarily an illogical position, but there
is reason to doubt its factual validity. If, a generation
ago, psychoanalysts were unable to recognize the presence
and operation of real guilt in persons fairly devastated
by it and so treated everyone as if they suffered only from
false guilt, why should we now trust them to make
exactly the right distinction between the two classes of
'"neurotics" which Jourard and many others are today
suggesting? Diametrically opposed types of "therapy"
would presumably be called for in the two different sit-
uations; and it is of some importance, obviously, that the
^'differential diagnosis" be made with precision and dis-
cernment. In the one instance, the goal of therapy pre-
sumably remains that of reducing the severity of the
superego, i.e., attempting to close the painful discrepancy
between a person's moral aspirations and his perform-
ance by lowering the level of the moral aspirations;
whereas, in the other situation, the therapeutic objective
is that of helping the patient become a better person,
i.e., to improve and raise the level of his performance.

When did psychoanalysts or, for that matter, secular
therapists in general, acquire special skill and competence
along these latter lines? Their formal professional train-
ing and theoretical orientation has been almost exclu-
sively in the reverse direction. When did they sud-
denly discover, if they have, that they are also uniquely
equipped to work with this other type of personality
disturbance? Even if the secular therapist were wise
enough to be able to tell in advance of treatment ("diag-
nostically") whether a given person falls into the one
category or the other, and even though he admitted he
had no special competence in dealing with the individual
suffering from real guilt, there is still an interesting ques-
tion as to what he would then do with such persons.
When the secular therapist today discovers that a patient
is suffering from a genuine moral dilemma or ambiguity,
rather than an imaginary ("neurotic") one, what does
he typically do — meticulously "refer" such a person to
pastoral counselors? Are secular therapists, who in the
past were so insistent that parish ministers and chaplains

. Theory of Psychopathology 225

jcognize their "limitations" and know when to "refer,"
ow recognizing their own hmitations and making coun-
;r-referrals? Or is the flow, for economic reasons, still
irgely in the one direction?

We cannot here hope to settle the question as to
hether there is indeed a residual class of persons who,
Freud insisted, suffer from over-conscientiousness,
ither than justified and realistic pangs of conscience.^

^A somewhat different way of approaching this problem has

;en suggested by Dr. H. J. Eysenck in his book, The Dyna-

ics of Anxiety and Hysteria: "In closing this chapter [on

acialization and Personality] we may fittingly return to the

ifference in opinion we noted in our second chapter between

lowrer on the one hand and Dollard & Miller [1950] on the

fcher. It will be remembered that in their theories of neurosis

lese writers were in sharp contradiction, Mowrer advocating

theory according to which the Id was too powerful as opposed

i) the Super-Ego, while Dollard & Miller [with Freud] advo-

ated a theory according to which the Super-Ego was too

erful as opposed to the Id. We can now see that these

heories are relevant, not to neurosis, but to extroversion-intro-

ersion. What we have called excessive degree of socialization,

ue to strong conditionability, these writers call Super-Ego;

/hat we have called insufficient degree of socialization, due to

;eak conditionability, these writers call Id. Mowrer appears

be dealing exclusively with the extroverted symptoms and

yndromes, Dollard & Miller with the introverted symptoms

nd syndromes. If there is any truth in our theory, then it will

te clear that both sides fail to come to grips with the problem

if neurosis, or excessive emotionality, i.e., that which is in

ommon to both hysterics and dysthymics, and deal rather

yith a continuum which is orthogonal to neuroticism. Thus

lur theory appears to reconcile the apparently contradictory

observations of these men in a larger synthesis. It also succeeds

n getting away from the reification inevitable in the use of

uch concepts as Id and Super-Ego, and it provides a mecha-

lism causally responsible for individual differences in these

espects which has a solid experimental foundation and whose

aws of functioning are reasonably well known. For all these

easons we venture to offer this theory as not only an alterna-

ive to, but as an improvement on, those of Mowrer, and

Dollard & Miller" (pp. 221-222). Like Jourard, Eysenck is

lere suggesting that there may be psychopathology on "both

;ides" of what he calls the extroversion-introversion scale, taking

ihe form of hysteria in the one case, anxiety (dysthymia) in the

3ther. Normality and abnormality then depend upon another

226 The Crisis in Psychiatry and RELIGIO^

But it will be useful to examine a few of the circum-
stances which do, to be sure, often give a superficial
impression of justification for the Freudian perception
of the situation. Typically, when adult human beings
present themselves for therapy, they are inhibited, de-
pressed, anxious, conscience-stricken. But this, manifestly,
is not their "normal" state of mind and being, to which
they long to return. Quite regularly, when we get into
the situation, we discover that a little while back these
persons have been something very far from inhibited,
repressed, unexpressive. A psychoanalytic friend of mine
used to be fond of saying: ''There is just one thing wrong
with the people who walk through the door of my office:
they haven't been having any funJ' They were, to be
sure, at the moment too depressed and too anxious to
enjoy life. But when we go into the question of how
they got that way, information is usually forthcoming
which clearly suggests a very different interpretation ol
the situation.

But what of the person who is more or less chronically
over-conscientious: the so-called obsessive-compulsive oi
the victim of religious scrupulosity? These are certainly
driven, tortured people; what is their underlying "dyna-
mics"? We can, of course, assume that Lady Macbeth
had a hand-washing compulsion because her mother (oi
nurse) was too zealous in "cleanliness training" and thus
gave to My Lady spuriously high standards in these mat-
ters. Or we can assume, as Shakespeare obviously did,
that the excessive preoccupation with "hand-washing"

variable, termed "excessive emotionality," which is independeni
of (orthogonal to) the first dimension. All of which, it seems,
tends to beg the question: What determines the proneness tc
this excessive emotionality? Dr. Eysenck has, I believe, toe
quickly and for logically insufficient reasons dismissed the
matter of id-ego-superego balance as irrelevant to the probleir
of neuroticism. And informal reports from his laboratory indr
cate that the empirical justification for his attempted re-^inter-
pretation may not be as substantial as it appeared to be (in
1957) when The Dynamics of Anxiety and Hysteria was pub-
lished. But it is, of course, very much to the good that Dr.
Eysenck and his co-workers have been willing to attack this
problem in terms of evidence other than that provided by mere
clinical observation and impression.

.

Theory of Psychopathology 227

/as energized by a displaced guilt which, in its own right,
i'as only too terribly real. In the case of the Catholic
mo must confess and confess, without deriving any
elief therefrom, may we not also reasonably suspect
with Stafford, 1950) that this compulsion continues
irecisely because the individual is careful to see that
lis "confession" never goes all the way, never really gets
the heart of the matter? It is, of course, not at all
lifEcult to find instances of displaced — and therefore
eemingly unrealistic, unjustified — guilt. We must be
areful not to accept a superficial perception of the
situation as basic and ultimate.

In light of considerations such as those just advanced,
ome may ask: But is it not possible that the picture has
hanged? Perhaps it is true that the majority of clinical
)roblems today involve real moral inadequacy or fail-
ire; but during the so-called Victorian era, in which
"•reud made his original observations and formulated his
heories, may not the picture have been typically other-
vise? We cannot, of course, say categorically that such
m interpretation is untrue, but it is improbable. Freud,
ve must recall, lived and worked in Vienna, which was
lever exactly famous for its prudery or restraint in sexual
natters. Besides, as Progroff (1956) has, recently pointed
)ut, Adler, Jung, and Rank (also Stekel and many
Dthers) broke with Freud, not on personal grounds, but
because they could not find in the clinical data justifica-
:ion for the inferences which Freud boldly drew. The
lata to which these men had access were essentially the
jame as Freud's, yet they could not agree with him, even
:hen (see also Ichheiser, 1960).

There can, of course, be little question that sexual
norality was somewhat stricter and probably better ob-
;erved 60 or 70 years ago than it is today. But the
question is: Was it excessively high then or is it danger-
ously low now? Many astute observers of the contem-
porary scene (LaPiere, 1959; Fitch, 1960) are suggesting
that the latter assumption comes closer to the truth of
the matter.

It is, of course, clear that man is more susceptible to
self-condemnation and therefore "neurosis" (if he han-
dles his guilt badly) when he holds high standards for
iiimself than when his standards are low or nonexistent.

228 The Crisis in Psychiatry and Religioi«

And as I have suggested on another occasion [Chaptei
9], Freud's "mission," as he conceived it (see Fromm
1959), v^'as to introduce a new era of "psychologica il
hberty" (Bakan, 1958). We are now far enough intc
this "era" to have both a retrospective and a prospectiv
view of it, which we do not seem to like. In simples
terms, it involves a level of morality and responsibility'
comparable to that of beasts in a jungle, each of whicb
"thinks" essentially of himself and his "natural" needs!
and has a minimum of social awareness. j

Recently an intelligent woman told me of a conver-i
sation she once had with an analytically-oriented child-
guidance expert. She said one of her teen-age sons' chores!
around the house was that of emptying the waste baskets.
Sometimes he was dilatory or refractory about doing this.
Now, asked the mother, "Should we require him to
perform this task or should we let him do as he likes
about the matter?" The reply was, "But why should
the boy have to do this if he doesn't want to. He didn't
ask to be born into your family." This may be one way
to avoid inner conflict in human beings, to let children
grow up as mere "blobs" (Robert Fitch's term!); but
socially and, in the long run, individually (see Link,
1937), it is surely a form of "treatment" that is worse
than the original "disease."

In light of the developments which have been alluded
to here, present-day apologists for psychoanalysis and
kindred "therapies" are fond of saying: "Yes, to be sure,
there were some inadequacies and errors in Freud's orig-
inal formulations and prescriptions. But there have been
great advances in our science since Freud's time." How-
ever, on close inspection, these alleged "advances" turn
out to be more nearly in the nature of retreats. One of
the allegedly great new developments in psychoanalysis
is the shift from the original emphasis upon unconscious
mechanisms to so-called "ego psychology," which in-
volves, essentially, a new emphasis upon what has always
been known as ego strength, character, or "will power."
One of the distinguishing features of Freud's doctrine
was its emphasis on "The Unconscious," and now this
is being abandoned in favor of "ego psychology," which
analysts are frank to say they as yet know very little about
"because it is so new to us and we are only beginning

\ Theory of Psychopathology 229

[0 investigate it." Common sense has been concerned
A'ith these matters for a very long time!

The most seminal and indigenous movement in Amer-
can psychiatry during this century has unquestionably
3een the emphasis of Harry Stack Sullivan (following
t.eads suggested by Adolph Meyer) upon the interper-
sonal nature of psychiatric problems, an emphasis which
fias been echoed, in one form or another by virtually all
of the so-called neo-Freudians, notably including Eric
Fromm and Frieda Fromm-Reichmann. But is this new?
Throughout history, the world over, it has been assumed
that there is a connection between "sin" and ''sickness,"
i.e., between how one deals with others and what happens
to oneself. The apostle Paul gave this principle its classi-
cal Christian formulation when he proclaimed that the
"wages of sin. is death," a psychological and spiritual
death (as opposed to the abundant life which comes
from the reverse of evil); but the principle itself is a
universal one and by no means exclusively Christian .^

No, the modification and revisions which Freud's fol-
lowers are having to make in their theories and practice
ire not extensions in the direction which Freud origi-
nally took, but are rather "advances to the rear." They are

^ Since the above was written, Dr. Perry London and I have
conducted a graduate seminar on "The Nature and Manage-
ment of Guilt," in which many of the foregoing issues were
considered. In response thereto, pro-Freudian students made
the following points: (1) Psychoanalysis is still a "young
science" and has perhaps not yet had a fair chance to demon-
strate what it can do. If one will pursue the references cited
in this paper, I believe he will come to question the grounds
for such optimism (if one can call it that!). And (2), a
related consideration: Granted that, during the half century
or so that psychoanalysis has been with us, the world has not
greatly improved, may this not be due to other factors — such
as urbanization and loss of primary-group contacts, the auto-
mobile and television, two world wars, etc.? In other words,
why blame psychoanalysis (the "Freudian Ethic") for all our
ills? Historical progression (or retrogression) is, of course,
always complicated, intricate, multi-faceted; and there is surely
no disposition on the part of anyone to hold psychoanalysis
exclusively responsible for the pervasive "sickness" of our
society. But, in the light of the varied evidence now available,
let's at least be very cautious about the continued assumption
that psychoanalysis is the cure.

230 The Crisis in Psychiatry and Religion'

reversals^ which are euphemistically — and misleadingly
— called "progress."

Ih IF ALL B IS A, IS ALL A, B?

OR ''the lord IS SLOW TO WRATH*'

On numerous occasions, a supposedly devastating criti-
cism has been leveled against the hypothesis that there
is a connection between moral failure and psychopathol-
ogy. Phrased in various ways, its basic form is this: If all
neurotic and functionally psychotic individuals have a
history of unacknowledged and unredeemed real guilt,
are all sinful, guilty persons neurotic or psychotic? Mani-
festly the latter is not true, and the stratagem underlying
this question involves an effort to discredit the whole
emphasis on moral considerations in mental illness by
means of a classical non sequitur. Elsewhere [Chapter 3]
I have called attention in this connection to that class
of persons who engage in thoroughly evil, antisocial
behavior but who simply do not have the character — or,
as one may say, the "common decency" — to go crazy.
It takes a fairly adequate personality to be seriously
""disturbed"; in fact, the very power of neurotic and
psychotic affects attests to their strength of character.

Also, some persons have the good sense to rectify
personal mistakes shortly after they occur and thus do
not allow themselves to fall into a chronic state of sin,
disgrace, "neurosis." But over and beyond these consid-
erations [cf. Chapter 10], there is another phenomenon
about which I should like to speak in a little more detail.

Imagine, if you will, a sort of "teeter-totter," such as
shown in Fig. 1. A child, let us assume, is normally born
on the left side. He does not at first have to proye"
himself. He is loved, accepted, "respected" because he is
our baby — and can, at first, do no wrong. But then, as
the months and years pass, we begin to make demands
upon him to "be good." Our approval is no longer auto-
matic, unconditional. In a word, the child's socialization
begins. Let us assume that all goes well in this connec-
tion and that, despite occasional mischief or naughtiness
(i.e., light forms of "sin"), this child remains basically
good, i.e., learns how to earn approval, respect, trust.
We say the child is developing well and deserves a good

A Theory of Psychopathology 231

-C:?

Fig. 1. Diagram suggesting how a gradual impairment of

\;self -respect {through continued wrong-doing) may lead to a

sudden emotional ''imbalance" or ''breakdown." Only by again

getting the virtue in one's life to outweigh the evil can the

balance be righted" and "equilibrium" restored.

deal of "credit" — which is represented by the "box"
shown on the left end of the teeter-totter and which is
experienced subjectively as self-respect.

The years pass. This child becomes an adolescent and
[is no longer under close parental supervision and guid-
ance. Now he (or she) begins to try his wings a bit, to
reality test." What would happen, our youth wonders,
if he tasted the "forbidden fruit." And he makes, let us
say, a brief excursion out on the wrong or "evil" end of
the teeter-totter and then retreats again to the good end.
Our young adventurer may have a little apprehension or
guilt" afterwards; but if he is "discreet" and doesn't
advertise" his foray, he may very well find, as did Adam
and Eve, that nothing happens! He then begins to
wonder even more: perhaps he has been swindled — ^by
his parents, by society. Perhaps, as we were fond of
saying in the 1920's, morality is "the bunk" and that
by observing it one loses out on all manner of good things.

The rest of the story follows a familiar script. Our
hypothetical youth returns to the wrong end of life's
teeter-totter again and again, and eventually decides to
remain there "in his heart" but to deny this overtly. Now
the "credit" begins to pile up on the other end. And
eventually a day comes — perhaps relatively soon, perhaps
only after many years — when something very "mys-
terious" happens: the teeter-totter tips into the position
shown by the dotted lines; and we say of our young (or
now perhaps not-so-young) friend that he has had a
nervous "breakdown," that he has lost his balance^
become unstable.

What, now, can a person in such a predicament do to

232 The Crisis in Psychiatry and Religion

be "saved"? It would appear that two equally misleading
answers have been given to this question in our time.
Protestant theology has preached a doctrine of "justifica-
tion by faith." Place your trust in God and believe on
Jesus Christ, we have been urged, and your sins will be
immediately forgiven. And for those who prefer a "scien-
tific" rather than a "religious" approach, there has been
the doctrine of "justification by insight." In the latter
approach, one comes to see that his sins are not real and
that he doesn't really need forgiveness. It is hard to
determine which of these doctrines has been the more
pernicious. Bonhoeffer, in his book The Cost of Disciple-
ship (1958), has eloquently condemned the conventional
Protestant approach to personal salvation and change as
a doctrine of "cheap grace" — and hence no grace at all.
And although psychoanalysis can hardly be accused of
being "cheap" in the monetary sense, its great appeal has
surely likewise arisen from the assumption that one could
buy his way out of perdition, without being otherwise
unduly inconvenienced or anguished.

For those who are now disillusioned regarding both of
these easy ways to "salvation," it is beginning to appear
that "the way" is indeed hard and the gate narrow.
Emotionally disturbed persons have not talked them-
selves into their difficulties; they have acted, misbehaved;
and many are now persuaded that one likewise cannot
talk (or pray) himself out of them. It is surely unre-
pented and unredeemed evil actions that destroy our
self-respect and moral credit; and one can hardly escape
the conclusion that these cannot be recaptured by any
means other than compensating good actions and deeds
[cf. Chapter 12].

A number of interesting and important implications
flow from this way of viewing sin and psychopathology.
To continue with the same physical analogy, it follows
that just as one does not immediately become neurotic
upon departing from virtue, so does one not immediately
become "well" by "being good" for a little while. One
has to work at it^ perhaps for a very considerable time.
But just as conscience eventually condemns and turns
against ("attacks") us for pursuing an evil life style, so
will conscience eventually approve and reward us for a
better type of conduct. To many modern-minded men

i\ Theory of Psychopathology 233

and women, traditional religious talk about the wonders
of ''faith" is not very intelligible or convincing. But, in
the present analogy, we nevertheless see the relevance of
faith, at least of a somewhat different kind. Just as the
fully destructive consequences of sin are not immediately
experienced, neither are the redemptive consequences of
i^irtue immediately forthcoming; and one has to have
'aith, confidence that redemption will eventually come if
3ne is only persevering. Many have tried to have faith
in conventional religion or in psychoanalysis and been
jorely disillusioned. But these are both purportedly easy
"orms of redemption. Genuine deliverance is, by contrast,
arduous but never, I believe, eludes those who stead-
"astly pursue it.

But what, one may ask, of those who "never had a
chance"? In illustrating the operation of the teeter-totter
principle, we deliberately selected an individual who had
been born to and reared by parents who were themselves
of good character, loving yet firm. But psychoanalysis
explicitly teaches that neurotic difficulties arise from
an excessively strong and unrealistically severe superego
which is created by the hostility, rejection, and moral
irrealism of parents. Hence, every neurotic is presumably
a person who "never had a chance"; and would-be therapy
all too often, therefore, takes the form of encouraging the
patient to wallow in self-pity and resentment, thus nur-
turing the paranoid tendencies which are already present
in so many "sick" individuals. Is it any wonder that the
accomplishments of such curative strategies are not im-
pressive?

Later in his life Freud was forced to admit that the
supposed correlation between neurosis and harsh training
in childhood could not be empirically confirmed. He
said: "If the parents have really ruled with a rod of iron,
we easily understand the child developing a severe super-
ego, but, contrary to our expectations, experience shows
that the superego may reflect the same relentless harsh-
ness even when the up-bringing has been gentle and
kind" (1933, p. 90). And when Freud then adds, can-
didly, that he has not "fully understood" this paradox,
we see how shaky is the whole theoretical and therapeutic
edifice which he erected. The doctrine of what might be
called "justification" by "circumstances over which one

234 The Crisis in Psychiatry and Religion

has no control" is thus pragmatically questionable and
leaves both the cause and cure of personality disturbance
completely up in the air [see Mowrer, 1961].

Also, I wish to call attention to a question which a
student raised when I lectured a few months ago at a
West Coast university. He said he wanted to know, quite
simply, what could be done to "save" persons who are
living on the wrong end of the teeter-totter but who
have not yet broken down, fallen. I had to tell him that
I, frankly, did not know. It is clear that "salvation" has
two aspects. One may speak of saving a fallen, manifestly
sick person in the sense of helping him to "rise again"; or
one can work preventively, to try to "save" people in the
sense of sparing them the anguish of an acute personality
crisis. But most of the efforts which we psychologists
have directed along supposedly hygienic or preventive
lines have probably been as misguided as our more
specifically therapeutic, or redemptive, efforts have been.
The leaders of Alcoholics Anonymous insist that an alco-
holic can't be "helped" until he "hits bottom"; and it
may be that much the same view is justified with respect
to other types of "confirmed sinners." But ideally there
ought to be something that could be done of a preventive
nature. This, of course, is the age-old problem of "evan-
gelism" — the hope of conversion prior to crisis, of calling
the "hard-of-heart" to repentance and reformation before
it is "too late." Certainly it should make some difference
what the prevailing ideology of a society is. So long as
we continue to assume that there is no relationship
between sin and psychopathology and that if, by some
mischance, one happens to crack up, one can always hire
an expert to put him back together again, wrong living
will hardly hold the implications of danger (and this is
an important part of what makes it "wrong") that it
ought to have. But the repudiation of the notion of such
a relationship has now proceeded so far that it is very
difficult to see precisely what steps can be taken to alter
either the specific modes of would-be therapy or the
general tenor of what passes for "mental hygiene."

In passing, it may be noted that there is today a re-
vival of interest on the part of religious leaders in the
concept of conversion, but with an attempt to avoid the
emotionalism of the traditional "revival" meeting.

Theory of Psychopathology 235

iii. what happens when psychoanalysis
IS "successful"?

A variety of studies (Ausubel, 1960; Cartwright, 1959;
Dollard, 1945; Eysenck, 1952; Masserman & Moreno,
1959; Ubell, 1958) have indicated that no form of
secular psychotherapy which has been around long enough
and practiced by a sufficient number of persons to have
a ''record" can boast of anything very substantial in the
way of accomplishment [see also Chapter 1]. When
the likelihood of spontaneous remission is taken into
account, the accomplishment is, in fact, almost exactly
nil. In other words, untreated controls (to the extent
that such controls are possible) seem to fare about as
well as treated groups.

All this, of course, is well known in professional circles
(e.g., see Fromm-Reichmann & Moreno, 1956) — and is
gradually leaking through to the public. But I was quite
unprepared to have an analyst tell me, a few years ago,
the following concerning the findings of the psycho-
analytic institute of which he was a member. Typically,
he said, he and his colleagues have found that psycho-
analysis has one of two outcomes: either the analysis is
technically unsuccessful, which means that it fails to
lessen the presumed over-severity of the superego, with
the result that the patient continues to be neurotic; or
the analysis is technically successful, i.e., the superego
is softened-up and inner conflicts are resolved, but the
patient then develops a "character disorder" and begins
**acting out."

Manifestly such a picture is not reassuring and con-
firms more systematic reports of negative therapeutic out-
comes and the growing popular disillusionment. But it
was only recently that the theoretical implications of the
report of my analyst friend dawned upon me. More than
a decade ago, I began suggesting that analytic theory is
wrong in at least one important respect: namely in its
insistence that repression goes in the "direction" of the
id, rather than (as I had come increasingly to suspect)
toward the superego. And if this surmise is sound, it has
important implications for the theory of character types.

If, as Freud insisted, the neurotic is a person with an

236 The Crisis in Psychiatry and Religion

excessively severe, over-developed superego or conscience,
the three major character types — criminal psychopath,
normal, and psychoneurotic — could be aligned as shown
in Fig. 2. Such an arrangement or conceptualization is
neither unreasonable nor unattractive, in some v^^ays. It
permits us, for example, to drav^ a standard, bell-shaped
distribution curve over these three personality classifica-
tions, v^ith the normal type of personality being ''aver-
age," model, and therefore most frequent, and v^ith the
two deviant forms of personality — psychopathy and psy-
choneurosis — trailing off in opposite directions. In such a
frame of reference, the therapeutic objective is, logically
enough, to help the patient move away from his position
of excessive superego severity, in the direction of psy-

Psychopath^^^"^ ^, , ^"^^^Neurotic

Fig. 2. Character typology inherent in Freudian psycho-
analysis. Therapy [broken arrow) in this system consists, logi-
cally enough, in trying to get the neurotic individual to "move'*
in the direction of psychopathy but to stop in the region of
normality.

chopathy, but to stop somewhere in between, in the
general area of normality (see short broken arrow). This,
of course, is in the direction opposite to that in which
the efforts of the home, church, school, and other socializ-
ing (character-building) institutions are largely directed
(see long solid arrow). And so it was that psychoanalysis
became a self-appointed and strident critic of socializa-
tion (cf. Freud, 1930), on the grounds that it is pre-
cisely those persons in whom this process has been most
effective and proceeded furthest that neurosis is most
likely to arise.

If, on the other hand, the neurotic's basic difficulty is
not that his superego is excessively severe but that the
superego has itself been repudiated and ''repressed" [cf.
Chapter 2], a very different character typology results.

A Theory of Psychopathology 237

as schematically portrayed in Fig. 3. Here the neurotic,
rather than being seen as over-socialized, over-controlled,
over-inhibited, falls somewhere in between the criminal
psychopath or sociopath, on the one hand, and the
normal type of person, on the other. Here it is assumed
that such a person has an essentially normal, basically
adequate superego but that it has been muted, dis-
regarded, dissociated. This constellation or arrangement
of character types might at first seem improbable, in that
it can be encompassed ''statistically" only if one uses a
i J-curve of the kind shown in the figure. To some this
type of distribution may seen anomalous; but the work

Psychopath.

Fig. 3. A more realistic character typology. Here it becomes
evident why a form of "therapy" which pushes the neurotic
individual to the "left" if it succeeds, produces a psychopath
rather than a normal person.

of F. H. Allport (1934) and his students has demon-
strated, more than 25 years ago, that the J-curve, far
from being anomalous, is typical of social phenomena;
and since character is manifestly a social product, we
should not be in the least surprised to find that it is dis-
tributed or varies, not according to the bell-shaped curve,
but in conformity with the J-curve.

Especially significant is the bearing all this has upon
the report of psychoanalytic failures and ''successes" cited
at the outset of this section. If the conceptual scheme
shown in Fig. 3 is valid, then a form of "therapy" which
attempts to push the individual toward psychopathy
would be expected to *'work" in precisely the way re-

238 The Crisis in Psychiatry and Religion

ported: either the therapy would be unsuccessful and
the individual would continue in his neurotic state oTy
if the procedure did "move" the individual character-
ologically, it would be over into psychopathy, not nor-
mality!

A few weeks before writing this paper, I happened to
sketch the foregoing considerations to a clinical psy-
chologist who has long been in private practice in South-
ern California — probably the most thoroughly analyzed
area in the world; and his comment was that he could
cite innumerable instances both of clear failure of psy-
choanalysis and of its negative ''success," i.e., instances
wherein it had been actively countertherapeutic — and
very few cases in which it had had a genuinely beneficial
effect.

As Bakan (1958) points out, psychoanalysis has, how-
ever, had its greatest impact, not as an individual therapy
(great as that has, of course, been ) , but as a broad social
ideology and personal philosophy. The Stanford sociolo-
gist, Professor Richard LaPiere, in his book The Freudian
Ethic (1959), advances cogent and numerous reasons for
thinking that, as a social ideology and philosophy, analysis
has been even more mischievous than as an individual
"therapeutic" procedure, if for no other reason than that
it has in this form affected so many more persons.

IV. PARANOIA AND SOCIOPATHY

If one adopts the view that neurosis arises, not from
personal irresponsibility and immaturity (see Fig. 3),
but from excessively high moral standards which harsh
and unreasonable parents (and other socializers) have
drilled and dinned into the individual as a child (see
Fig. 2), it follows, ineluctably, that the individual is not
"to blame" for his so-called neurotic difficulties. It is
rather his father, mother, siblings, teachers, minister —
anyone but himself. And soon the analysand, under this
pernicious tutelage, is luxuriating in self-pity and smol-
dering resentment. If there are any paranoid trends al-
ready present, how else could they be more effectively
fanned and fed? The distinguishing feature of the para-
noid is that, unlike the depressive, he typically projects

A Theory of Psychopathology 239

his own outraged conscience out upon others and then
perceives them as "after" him, and against him.

Thus, it seems reasonable to infer that psychoanalysis,
in its classical form and strategy, would drive individuals
toward both sociopathy (psychopathy) and paranoia. We
have already seen that the first of these outcomes does
in fact occur. In ''successful" individual analysis and in
the movement of society as a whole which has been
encouraged by the "Freudian Ethic," we see the trend
toward the "psychological liberty" which we first thought
was going to be our salvation but which we are now
'beginning to view instead as a scourge. While in South-
ern California I repeatedly heard stories from clinical
psychologists, ministers, and social workers concerning
the youth of the "best families" in their communities:
'i.e., families with money, education, leisure, and exten-
sive psychoanalytic therapy. And what was the picture?
The youth of such families, with distressing frequency,
present a picture of demoralization: little personal ambi-
tion, self-centeredness and selfishness, dope addiction,
general defiance and insubordination, illegitimate babies,
and the rest.

The situation came particularly close to me in the
following incident. At the home of one of my friends, I
was casually watching a little girl (perhaps four years old)
and her mother in an adjoining yard. The child was
throwing a ball for a kitten to chase and having some
difficulty with her coordination. Presently she made a
particularly awkward throw; and I heard her say, "Oh,
God! God damn it!" as casually as a child of an earlier
generation might have said, "Oh, my!" or possibly "Drat
it!" Her parents have very likely had the benefit of our
best schools and colleges; and if they have not personally
"had therapy," they know well the direction in which
one is supposed to "move" therein and how, according
to therapeutic doctrine, to bring up children without
neurotic scruples and inhibitions. The difficulty is that
we thus also bring them up without character.

Following a lecture in another state, a middle-aged
woman tearfully spoke to me about her grown son: he is
now, she says, himself trained as a social worker but has
been "in analysis" for several years and still is; and as a
part 0/ his therapy he has been encouraged to blame his

240 The Crisis in Psychiatry and Religion

mother for all his difficulties, has little or nothing to do
with her, and seems to be increasingly paranoid and
hostile in his general outlook. Recently a psychologist
told me (I unfortunately have misplaced the reference)
of a factor-analytic study in which paranoid and socio-
pathic traits come out as a single factor. This is hardly
surprising, since both types of individuals perceive their
trouble as "out there/' as indeed it is for the sociopath;
and although the paranoid individual has, more than the
sociopath, internalized the norms of the culture, he
rejects them so strenuously that he can experience them
only in projected (delusional) form. How astonishing
that we should have adopted as ''therapy" an ideology
and interpersonal strategy which we are now beginning
to see moves us away from the more benign forms of
personality disturbance (depression, anxiety states, etc.),
not toward normality, but toward the two most malignant
forms of personality deviation known to man! ^

*Here I wish also to comment upon a question which is
posed by the undedying logic of this paper. As we know, the
prospect of recovery is always good in the depressions but, at
least with present methods of treatment, poor in schizophrenia.
Why should this be the case? Many contemporary students of
the problem are inclined to agree that depressions are pre-
dominantly "psychological," i.e., involve a "working through"
of personal problems but assume, because of its greater chron-
icity, that schizophrenia has a more constitutional, or endog-
enous, basis. In his 1936 book. The Exploration of the Inner
World, Anton Boisen advanced an intriguing hypothesis which
has, I feel, received too little consideration: namely, that
schizophrenia tends to be chronic and, not infrequently, "pro-
gressive" because the individual manifesting this disorder "re-
fuses" to admit his guilt and undergo appropriate remorse or
make fitting restitution. Perhaps sociopathy and schizophrenia
are, therefore, presently "untreatable" for much the same
reason: in both conditions the individual does not take respon-
sibility for his antisocial and immoral acts; but the symptom-
ology is different because, as indicated above, the sociopath
(as a type) has no conscience whereas the schizophrenic has
one but projects it. The depressive, by contrast, "gets well"
because he has a conscience and, through the depression, comes
to terms with it. If this understanding of the situation is vahd,
it might lead to important innovations in treatment: notably,
an approach which would help the schizophrenic move, not
toward sociopathy, but toward the depressive syndrome.

A Theory of Psychopathology 241

Elsewhere (p. 163) I have quoted Schiller to the effect
that "Life may not be the highest possession, but guilt is
the greatest evil." Nietzsche's ''Superman," we recall, was
to live beyond good and evil, without guilt; and Adolf
Hitler, World War II, and the mass extermination of
Jews were some of the horrid manifestations of this dream.
More subtle but nonetheless insidious and deadly, the
Freudian Ethic implies the same philosophy in another
guise. And it is no accident, surely, that it has prepared
the way in this country for the widespread and growing
interest in Zen Buddhism. One of the Chapters in Alan
W. Watts' (1959) book. The Way of Zen, opens with
this Zen Buddhist poem:

The perfect Way is without difficulty.

Save that it avoids picking and choosing.

Only when you stop liking and disliking

Will all be clearly understood.

A split hair's difference.

And heaven and earth are set apart!

If you want to get the plain truth.

Be not concerned with right and wrong.

The conflict between right and wrong

Is the sickness of the mind.

On the front of this book is a Buddha, arms folded,
eyes closed, and countenance inscrutable. How different
are the outspread arms and open countenance of Christ!
Why this abandonment of the Judeo-Christian faith for
Nietzsche, Freud, and Zen? The answer, I believe, can
only be found in certain features of the Protestant Ref-
ormation, especially as they were shaped and expressed
by John Calvin. His doctrine of predestination and human
helplessness paved the way for the despair of Kierkegaard
and the anger of Nietzsche. Roger L. Shinn in The Exis-
tentialist Posture (1959) credits Nietzsche with saying
that "The churches are the tombs of God" and Kierke-
gaard with accusing "the churches of making a fool of
God" (p. 70). It would appear that some revisions in
the realm of theology are quite as urgently needed, if
our civilization is to survive, as are called for in the area
of secular "therapy."

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Bultmann, R. K. {See Niebuhr, 1960) [184].

Burkhart, R. A. [221].

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Byron, G. [201].

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244 Bibliography and Author Index

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Bibliography and Author Index 245

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246 Bibliography and Author Index

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Fromm-Reichmann, Frieda and Moreno, J. L., Eds.
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Galileo [111, 112, 122].

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Gandhi, M. [145,146].

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Bibliography and Author Index 247

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Haitzmann, C. (See Freud, S., 1923 [118].

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Hegel, G.W.F. [143].

Hepburn, Katherine [140].

Hitler, A. [241].

Hobbs, N. (1956). Curing Unreason by Reason: A re-
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Hoch, P. H. {See Fromm-Reichmann and Moreno,
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Hocking, W.E. [66].

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248 Bibliography and Author Index!

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Levy, D. (Personal Communication) [151]. 1

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Lowy, S., and Gutheil, E. A. (1956). Active Analytic
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Luther, M. [9, 105, 106, 109, 185-187, 190].

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Macalpine, Ida, and Hunter, R. A. (1956). Schizo-
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Marx, K. [173]. i

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Bibliography and Author Index 249

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Mesmer, F. A. {See Steiner, 1958) [70].

Meyer, A. [229].

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Michelango [115].

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Miller, A. (1955). In The Renewal of Man (R. Nie-
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Million, E. [154].

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250 Bibliography and Author Index

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Nietzsche, F. (1887). The Genealogy of Morals (F.
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Perkins, Sara E. (1956). My 4V2 Years in a Chinese
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Pirandello, L. [179].

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Bibliography and Author Index 251

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Rank, O. [21,24,227].

Richards, I. A. [149].

Riese, W. (See Shoben, 1957) [39].

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Schiller, J. C. F. [163-164,170].

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Shakespeare, W. [88, 217, 226].

Shinn, R. L. (1959). The Existentialist Posture. New
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Smith, H. (1960). Toward a Socially Responsible Uni-
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Solomon, H. C. (1958). The American Psychiatric As-
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Steiner, L. R. (1945). Where Do People Take Their

252 Bibliography and Author IndejI

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Tournier, P. (1957). The Meaning of Persons. New
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Bibliography and Author Index 253

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West, R. F. (1959). Light Beyond Shadows. New York:

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White, E. (1955). Christian Life and the Unconscious.

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Williamson, E. G. (1956). Counseling in Developing

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Wilson, A. (1954). Pardon and Peace. New York: Sheed

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Wortis, J. (1954). Fragments of an Analysis with Freud.

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Zilboorg, G. {See Fromm-Reichmann & Moreno, 1956)

[3]-

Subject Index

Absolution, doubtful, 106

and forgiveness, 195
Abstractions, Asiatic, 182
Acceptance, 1 3, 78
Accountability, 40, 5 3

one-sided, 159

social, 43
Acting out, 235
Action, vs. insight, 46, 1 39

prescription for, 137, 221

redemptive, 232

in sin and salvation, 78
Action Research, 176
Affiliation, social, 12
Agitation, following confes-
sion, 99, 104
Alcoholics Anonymous, 46,

109, 140, 150, 233
Altruism, 13
Ambition, 106
Anti-Semitism, 117
Anxiety, and confession, 99,
104

and estrangement, 148

as a fever, 99, 104

friend or foe, 33

and repression, 120

theoryof, 68, 83, 148
Apology, 202
Asceticism, 9

waning, 10
Atonement, a bloody doc-
trine, 188

outmoded, 199

rituals of, 102

substitutionary, 147, 188,
189
Authority, and competence,
51, 219

lack of, 218

sacramental, 174

Balance sheet, moral, 1 89
Bankruptcy, moral, 152

Behavior theory, 1 5
Behaviorism, 4, 6, 15

antiquated, 5
Believers, priesthood of, 150
Belongingness, 13
Bible, consistency of, 188
Blame, and neurosis, 49
Breakdown, nervous, 153,

231
Buchmanism, 109

Calvinism, indefensible, 183
paradoxes of, 159
a perversity, 1 60
and psychoanalysis, 1 60
Catholicism, and absolution,
150
a challenge to, 208
and mental health, 107
metaphysical claims of,

204
paradoxes of, 204, 206
and science, 111
and works, 189
Catholics, mental health of,

194, 204
Character, and community,
214 ff.
and guilt, 213
and neurosis, 43
strength of, 215, 230
typology, 236
Character disorder, 235
Charity, 13

commercialized, 166
and personal change, 219
secret, 198
Chastisement, redemptive,

219
Cheap grace, 190,232
Chemotherapy, 13, 44, 51,

59
Christianity, and Judaism,
112

254

UBjECT Index

a minority movement, 172

uniqueness of, 182

hurch, and state, 166

hurches, a challenge to, 60,
169

default of, 59

and mental disease, 61, 162

openness of, 71

reformation of, 172

lergymen, competence of,
171

inconsistency of, 157, 186

as professors, 174

psychoanalyzed, 160

linical movement, deflec-
tion of, 64

linical training, for clergy-
men, 62 ff.

limitations of, 73

ommunication, 83

ommunity, 180

achievement of, 147, 191

and character, 214 flf.

of sinners, 191

ompetence, interpersonal,
12

ompulsion, 226

onfession, 43, 91 ff., 180

and absolution, 99

and action, 78, 102

and agitation, 99

and atonement, 101

Catholic, 109, 201 ff., 227

and community, 147, 214

of crime, 99

defects of, 194

as a deterrent, 195

directly to God, 202, 216

and honesty, 215

to laymen, 107, 195

vs. insight, 107

insufficient, 94, 104, 202

motivation for, 75

objections to, 190, 193

officially sanctioned, 190

and openness, 109

in Protestant Churches,
193

or psychoanalysis, 192

reconsidered, 192

and recovery, 220

relief from, 95

and restitution, 55, 83

return to, 137, 189 ff.

255

as a sacrament, 201

in the sects, 140

therapeutic, 92, 193,
201 ff.

three steps in, 191

value of, 175

well received, 98

why necessary, 202

without recovery, 98
Confidence, need for, 233
Confinement, and expiation,

100
Conflict, in Catholic posi-
tion, 207

constructive aspects, 25

ethical, 146

between Freud and Moses,
114

moral, 214

in psychopathology, 1 54

in religion, 66

and repression, 20

resolutions of, 144

of science and religion, 183

in the seminaries, 63

in therapeutic relationship,
95
Conformity, paradox of, 130,

144
Conscience, approval by, 33,
216,232

clear, 188

combatting, 114

compared with court, 100

diseases of, 22, 37, 68

distrust of, 37

externalization of, 32, 240

and eyes, 94

fairness of, 196

morbid, 64

and neurosis, 31

outbreak of, 153

outraged, 126, 239

and paranoia, 239

as prattler, 67

projected, 32, 240

protests of, 25

and recovery, 64, 240

rejection of, 84, 240

repression of, 29, 68, 127,
206

and rigidity, 5 5

and the unconscious, 17

value of, 162

256

variations in, 27
vengeance of, 23
as voice of God, 32
Conscientiousness, false, 223
Constitution (see C)rganic-

ism)
Consumption, conspicuous,

146
Conversion, 57, 234
Counseling, as confession, 78,
137,190
and psychotherapy, 33,
107 ff.
Courage, 31

Creativity, vs. conformity,
144
myth of, 143
Credit, moral, 231
Crime, and punishment, 100

and retribution, 1 68
Criminals, rehabilitation of,

102
Crisis, institutional, 1 38

moral, 151
Culture, disunity of, 143

Demoralization, social and

personal, 239
Depersonalization, 216
Depression, and guilt, 91, 97

vs. paranoia, 240

self -limiting, 100
Despair, Christian, 160

and the devil, 117
Determinism, 58

psychic, 159
Deviance, open, 153
Devil, as cure for depression,
116

Freud identified with, 114-
116

and the id, 122

powers of, 118

as principle of evil, 119

as a projection, 125

and psychopathology, 80,
114

as suspended superego,
117,125

as tempter, 117
Diagnosis, differential, 224
Dick Tracy Theory, 86 ff.

objections to, 88

Subject Index

Discipline, and normality, 42

penitential, 192
Disgrace, and disease, 82
Disillusionment, 235
Disobedience, with integrity,

145
Dissociation, 165
Drug Therapy {see Chemo-

therapy )
Duplicity, destructive, 146

Economy, expanding, 146

Education, public, 166

Ego psychology, 31 E, 34,

45, 228
Ego strength, 34, 36
Electrotherapy, 111
Embezzlement, 152
Emotionality, excessive, 226
Encounter, 179
Equilibrium, moral, 231 (see

also Balance sheet)
Estrangement, 131
Ethics, and psychopathology,
130
and society, 146
Evangelism, 234
Evidence, canons of, 171
Evil, and bondage, 31
corporate, 122, 146
personal and secret, 147
problem of, 142 ff.
Evolution, evidence for, 14
and psychoanalysis, 1 5
and psychology, 4 ff.
theory of, 1
Existence, meaning of, 52

moral basis of, 5 3
Existential Analysis, 1 80
Existentialism, 52, 177 ff.,

184, 185, 241
Ex-patients, as therapists, 218
Experience, denial of, 164
Expiation, 97 ff.
Extroversion, 225
Eyes, as conscience symbol,
94

Faith, reinterpreted, 233

and works, 221

without works, 187
Father, corruption of, 96
Fear, and authority, 213

in schizophrenia, 86

of sex, 213

iuBjECT Index

^ees, and self-punishment,
141

i'ellowship, 13
"orgiveness, 25

not accepted, 197

too easy, 188

over-worked, 188

and prayer, 214

presumption of, 196

and psychoanalysis, 175

questionable, 195, 196
; traffic in, 106, 110, 138
.^'raudulence, personal, 150
^'ree association, 101
"reedom, and alienation, 52

loss of, 31
F'reud, and depression, 117

as the devil, 116, 132

his mission, 131

as Moses killer, 115
^'reudian Ethic, 241
E^'reudianism, 131, 165
F'unctionahsm, 4, 6, 8, 1 5
F'undamentalism, 61, 165

l^lory, lost, 173

I^od, conceptions of, 37, 114

and conscience, 29, 37, 59,
67

faith in, 37

flight from, 155

grace of, 159

hand of, 30

inscrutability of, 160

of justice, 59

as love, 59

love of, 219

manifestations of, 79-80,
123

as person, 182

and psychopathology, 79

short-cut to, 106, 216

and sin, 185-187

and the unconscious, 128

unpredictable favor of, 159

wrath of, 28 ff., 79-80, 188,
219
Good Works, condemned,
158

among Mormons, 209

objections to, 198

and redemption, 232
Grace, costly, 108

debased, 149

257

and disgrace, 1 89
the gift of God, 186
inadequate, 100, 108, 189
over-emphasis on, 106

(see also Cheap Grace)
Group dynamics, 177
Group practice, by clergymen,

_ 218
Guilt, analysis of, 32
attitudes toward, 57
barrier to marriage, 210
a central problem, 167
and confession, 91 ff.
conscious or unconscious,

148
constructive, 25, 64
definition of, 81, 130,

142 ff.
displaced, 82, 227
and divine grace, 175, 181
as an evil, 164
excessive, 75
false, 175,200,213
feeling or fact, 105
vs. guilt feelings, 56, 104
harmful, 66

historically considered, 105
imaginary, 81
and incest, 209
legal, 167
masks of, 59
mismanagement of, 59
as motivation, 199
and neurosis, 126, 213
in psychoanalytic theory,

82
and psychopathology, 217
reaction to, 54
real or false, 56, 68, 81,

89, 142, 190
reality of, 83, 213, 217,

230
beyond religion, 190
and self-loathing, 223
and social reality, 223
and the state, 167
and superman, 241
not taken seriously, 128
taken seriously, 108, 109
unatoned, 131
unresolved, 200

Hallucination, and con-
science, 94

258

Subject Indei

Healing, through confession,

or confession, 107

202

and neurosis, 41, 78

Hell, eliminated, 59

vs. repentance, 100

and neurosis, 48

not sufficient, 197

in religious thought, 61

Insurance, and charity, 166 ]

as state of mind, 42

Integration, 215

Helplessness, of man, 241

into society, 215

in sin, 241

Integrity, 217

Holy Spirit, basis of all re-

and ego strength, 146

ligion, 124

and personal identity.

and emotional disturbance,

177 ff.

154

value of, 216

and a new synthesis, 131

Introversion, 225

and reformation, 173

Inventiveness, social, 176

significance of, 123 ff.

Investment, personal, 1 39

and the unconscious.

Irresponsibility, 238

125 ff.

religious and psychoanaly]

Honesty, contempt for, 146

tic, 160

and mental health, 145,

Isolation, personal, 25

215

social, 92

Hospitalization, 157

and temptation, 147

after confession, 99

Issues, vs. troubles, 135,

Ul

by religious groups, 218

Hospitals, church directed, 79

Jealousy, 36

failure of, 76

Jesus Christ, as person.

18*

inadequate, 167

revelation in, 182

as mission field, 79

Judaism, 112

under-churched, 79

Judgment, moral, 40

Hostility, fear of, 83

and suffering, 56 ff.

Hypnotism, 111

Justification, by faith.

158

Hypocrisy, 152,202

232
by insight, 232

Id, and the devil, 122

in Protestant doctrine,

17.

Identity, denial of, 217

and integrity, 177 ff.

loss of, 52

and neuroticism, 216

quest for, 135
Ideology, 234
Illness, defended, 203 ff.
Immaturity, 238
Impulse, repression of, 36,

160
Incest, 209

and insanity, 147

and psychopathology, 96
Indulgence, 105
Inhibition, and character,

237
Injustice, 161

and psychopathology, 161
Insanity, and character, 230

and isolation, 148
Insight, vs. action, 1 39

Kabbala, 112ff.
Knowledge, tree of, 121

Latter-Day Saints, 208

salvation in, 212
Laws, universal, 183
Learning theory, 31
Liberation, emotional, 67
Life, abundant, 10
Life style, changes in, 153
Lost sheep, 169, 171, 173
Love, and charity, 57

of God, 154

and relatedness, 148

Man, and community, 155
cultivated, 179
disillusioned, 175
fall of, 120
helplessness of, 159, 165

|UBjECT Index

nature of, 35, 54, 153, 178,
179

predicament of, 175

science of, 180

self-domesticated, 38

a social creature, 131
/lartyrdom, 106
Masochism, 141, 199
/laterialism, 8
/laturity, and religion, 71
/ledicine, aggrandisement of,
50

and morality, 58

and psychology, 50

and suffering, 58
v/[editation, 113
viemory, and illusion, 178
viental Hygiene, and mo-
rality, 9 ff.
viental illness, a questionable

concept, 51
Viesmerism, 70
Vlind, and adaptation, 1

survival of, 16

theories of, 5
Vlind-body problem, 2 ff.
Vlissions, foreign or do-
mestic, 78
Vlistakes, correction of, 151
Mobihty, downward, 153
Morality, 227

apathy toward, 58

and psychopathology, 23,
58, 197

and skepticism, 41
VIoses, attacked by Freud,
114

the lawgiver, 115

ursurped by Freud, 115
Mystery, religious, 187
Mysticism, 185

and chaos, 182

and psychoanalysis, 113

f^aturalism, and the Bible, 30
Natural law, 125
Needs, psychological, 16
Negativism, moral, 181
Nemesis, 200
Neo-Freudianism, 161 ff.
Neo -orthodoxy, 184
Neurosis, cause of, 226
and character, 43

259

and childhood training,

233
and estrangement, 25, 169
as illness, 50
two kinds, 223
and morality, 8, 24, 44,

238
nature of, 26 ff., 54
presenting symptoms of,

226
and responsibility, 48
and retribution, 200
so-called rigidity in, 31
and sin, 48
and socialization, 34
theory of, 1 5
Neurotics, held blameless,

160
no interest in, 110
life history of, 84
Nihilism, intellectual, 181

moral, 241
Nonconformity, constructive,

145
Normality, 236
conditions of, 34
and rectitude, 151
and values, 34

Objectivism, 5

Openness, and integrity, 145
Organicism, 44, 240
Oxford Group, 35, 109

Paranoia, 151

vs. depression, 240
encouragement of, 233,

238
immutabihty of, 101
and resentment, 101
and sociopathy, 240

Parapathy, 23

Parents, and conscience, 59
influence of, 233, 238

Penance, 195, 197

Performance, level of, 224

Persecution, ideas of, 98

Personality, types of, 236

Persons, or principles, 180 ff.

Personology, 177

Perversion, and depression,
97

Phenomenology. 179

Philanthropy, 219

260

Philosophy, and counseHng,

Iff.
Phrenology, 70
Positivism, 5

Possession, and neurosis, 116
Prayer, or action, 221

use of, 220
Preaching, and guilt, 75
Predestination, 109, 187, 241
Pretense, and guilt, 147
Pride, sin of, 187, 198, 220
Principle, return to, 185
Principles, universal, 182
Private practice, 77
Promiscuity, and guilt, 98
Protection, legal, 218
Protestant Reformation, 39,
241

ambiguities of, 176

incomplete, 110

and psychotherapy, 105,
156

rejection of confession, 106
Protestantism, and ambition,
106

and guilt, 77, 106, 157,
214

highly intellectual, 174

paradoxes of, 107, 164

and psychoanalysis, 160,
175, 190

and science, 112

twilight of, 174
Psychiatry, ambiguities of,
200

changes in, 90

competence of, 161

interpersonal emphasis, 229

the new faith, 67

of Old Testament, 29

and religion, 28
Psychoanalysis, 1

advances in, 45, 161, 228

alternative views, 20 ff.

blandishments of, 83

a big business, 149

and Christianity, 127

vs. confession, 203

not confirmed, 54

cost of, 140

criticisms from, 236

defectors from, 227

demise of, 22

demoralizing, 239

Subject Inde

and the devil, 114
disillusionment regarding,

15
disintegration of, 123, 22
paralyzing effect of, 133
as a new ethic, 133, 23
fallacies of, 54
history of, 1 10 ff .
and humility, 69
impact on clergymen, 73
impact in religion, 60,

65 ff., 134
inception of, 82
inconsistent, 233
and Kabbalism, 113 ff.
and medical science, 49
nontherapeutic, 161, 162
permissiveness of, 228
not for poor, 149
premature acceptance of,

50
presumptions of, 17
a pseudo-science, 176
re-appraisal of, 60, 68
and religion, 111, 159 ff.
vs. religion, 69, 112
vs. religious therapy, 24 ff
resistance to, 165
results of, 121, 133, 159

235,237,238
as science, 70
self-centered, 220
and sociopathy, 2 37
spoofing of, 5 3
therapeutic strategy of, 82
as surgery, 38
as therapy, 63, 175
as way of life, 114
weaknesses of, 1 32, 222 ff.
Psychoanalyst, omniscience

of, 17, 121
as tempter, 118
worry-free, 141
Psychologists, and psycho-
analysis, 50
Psychology, academic, 1
attraction of, 149
and biology, 4 ff.
crisis in, 2
and evolution, 1 5
and moral competence, 9
and theology, 52
Psychopathology, attitudes

toward, 66

Subject Index

and conduct, 84

and duplicity, 146

history of, 28, 103 ff.

and ideology, 51

among monastics, 203

moral basis of, 61, 91,
103, 190

nature of, 18, 81 ff.

needed research, 84

prevalence of, 7, 157, 208

redemptive, 219

re-interpreted, 83

religious rejection of, 205

without repression, 29

and sin, 234

social basis of, 17, 90

and social values, 1 6

susceptibility to, 163

theory of, 151

value of, 58
Psychopathy, 38, 235

(see also Sociopathy)
Psychosis, as disease, 203

hazards of, 78

a state of sin, 148
Psychotherapy, accomplish-
ments of, 235

as a business, 77

chent-centered, 164

and cultural change, 115

in disarray, 3

goals of, 237

as guide to morality, 67

limitations of, 140, 213

nontherapeutic, 17, 101,
138

reform of, 72

re-orientation of, 105, 240

and seduction, 93

talk or action, 101

and values, 103 ff.
Punishment, need for, 199

role in therapy, 56-57

of sinners, 5 3

value of, 39

Real guilt, not recognized,

224
Reality testing, 231
Reconcilliation, of science

and religion, 184-185
Recovery, and personal

change, 55
from psychopathology, 240

261

or reformation, 153

and self -blame, 101
Redemption, 148 ff.

not easy, 149

not for sale, 149

and recovery, 55

and reform, 141
Referral, 45

to other clergymen, 218

dubious, 224

to psychiatrists, 169

rationale of, 74
Reformation, 9

contemporary, 15, 105

incomplete, 171 ff.

must continue, 172, 176

a permanent movement,
172

value of, 166
Rejection, ambiguity of, 9 3

of seductiveness, 95
Relatedness, rupture of, 90
Relationship, 180

interpersonal, 12 ff.
Release therapy, 125
Religion, abdication of, 167

and action, 182

authenticity of, 62, 169

clinical interest of, 61

two dimensions of, 110

in disrepute, 122, 168

great potential of, 76

impotence of, 112, 157

inadequacy of, 168, 197

and medicine, 62

and mental health, 11, 32,
52

and mental hygiene, 3

predicament of, 60, 69

priestly or prophetic, 140

prostration of, 1 36

and psychoanalysis, 52,
111, 159

as psychology, 1

as psychopathology, 10, 63

return to, 135

revitalization of, 80, 136,
168

and science, 14, 66 ff., 82

scorned by Freud, 159

shame of, 111

subordination of, 76

and theology, 220

therapeutic, 212

262

and the unconscious, 28

vitality of, 1 1

weakness of, 110
Religiosity, increasing, 123
Remission, spontaneous, 235
Remorse, repression of, 68
Repentance, 100

call to, 30

and change, 234
Repression, 18 ff.

direction of, 26 ff., 35, 126,
235

dynamics of, 19

vs. ego controls, 36

elusive, 84

failure of, 8 3

Freudian, 26, 36

and guilt, 26

theory of, 127

and the unconscious, 19 ff.
Research, limitations of, 176

need for, 81
Resentment, 238
Resiliency, 151
Resistance, nonviolent, 145
Resolution, and redemption,

105
Responsibility, abandonment
of, 240

and forgiveness, 196

moral, 43, 56

and neurosis, 31, 48

rejection of, 58
Restraint, and recovery, 38
Restitution, 152, 240

or retribution, 168
Resymbolization, 173
Retribution, 167, 200

vs. restitution, 102
Revelation, divine, 125
Revolution, cultural and
moral, 131

psychiatric, 132
Righteousness, self-pro-
claimed, 109
Rigidity, neurotic, 55

Sacrifice, misinterpreted, 189

and recovery, 219
Salvation, by grace, 186

by psychoanalysis, 182

not for sale, 140

a social operation, 221

Subject Index

spurious, 232

theories of, 109

two kinds, 2 34

uncertainty of, 1 60
Salvation Army, 135, 140,

150
Sanity, and humanity, 38
Satan, 119

Schizophrenia, and criminal-
ity, 89

Dick Tracy Theory of, 86

diverse opinions of, 87

and fear, 86

as interpersonal disorder,
126

and isolation, 92

loss of self-esteem in, 87

malignancy of, 101

and possession, 116

and pretense, 87

as progressive terror, 104

and secrecy, 87

and sexual deviation, 90

a social disease, 89

theory of, 84, 85 ff.
Schizophrenics, basically de-
cent, 89

indifference of, 87

pseudoneurotic, 90
Science, and religion, 125,

176, 184-185
Scientism, 58
Scrupulosity, 65, 206, 226
Secrecy, and ego weakness,
215

and shame, 148
Secularization, of various

functions, 166 ff.
Seductiveness, of client, 93

as defense, 95
Self, as social phenomenon,

13
Self-acceptance, 162

and sociopathy, 163
Self-condemnation, 219

capacity for, 161, 227

in psychopathology, 161
Self -contempt, 163
Self-disclosure, 83, 108
Self-examination, 178
Self-interest, 217
Self-knowledge, 178

through confession, 192

vs. self-revelation, 180

Subject Index

Self-pity, 238

in psychotherapy, 1 64
Self-punishment, construc-
tive, 66

in depression, 100

disapproval of, 163

unjustified, 161
Self-rejection, 211
Self-respect, recovery of, 202
Self-revelation, cpst of, 190
Self -revulsion, 151
Seminaries, uneasiness in, 73
Service, as sacrifice, 199
Sex, and neurosis, 23

and social adjustment,
214 ff.
Sexuality, acceptance of, 75

fearof, 83, 213

repressed, 119
Shame, and salvation, 55
Sickness, concept of, 39

over-extension of, 168

and pessimism, 40

or salvation, 153

vs. sin, 75

a stultifying concept, 138,
142
Significant others, 108
Sin, acceptance of, 54

act or attitude, 186, 188

and atonement, 188

definition of, 42

and delusion, 98

and depersonalization, 185

destroys community, 191

and expiation, 199

forgiveness of, 232

helplessness in, 165

and mental sickness, 205

objections to, 41

original, 147

and psychopath ology, 148,
232

due to psychopathology,
205, 211

and punishment, 53

and redemption, 51

re-evaluated, 40

repression of, 160

and secrecy, 148, 216

and self-hatred, 54

vs. sickness, 43, 50, 67, 82

or sickness, 87, 91, 229

and sins, 185 ff.

263

and sociopathy, 43

and suffering, 43, 48

as therapy, 205

unpardonable, 66, 98

and worldly hell, 42
Sincerity, violation of, 86
Sinners, confirmed, 234
Social act, 140
Sociality, 2, 220

betrayal of, 131, 155

loss of, 86 ff., 90

man's inveterate, 153

restored, 202
Socialization, 225, 230, 233

and neurosis, 48

opposition to, 236
Society, basic premises of, 147

debt to, 100

nature of, 38

presupposes conscience,
162

and religion, 173
Sociology, and self-theory, 13
Sociopathy, 27

and paranoia, 239

(see also Psychopathy)
Souls, the cure of, 192
Spiritual directors, 194
Strength, personal, 198 ff.
Suffering, misinterpreted, 58

in psychopathology, 56 ff.

redemptive, 58
Suicide, 151

and Catholicism, 107, 194
Superego, harshness of, 54,
66, 114

as introjected parents, 161

irrational, 32

and Mosaic law, 115

a negative agency, 127

power of, 223

repression of, 236

severity of, 233, 235

tyrannical, 158, 225
Survival, psychological, 6 ff.,
16

question of, 1 39
Symptoms, and anxiety, 26
Synthesis, of psychology and
religion, 103

Talion, 200
Taoism, 181
Testimony, 14

264

Theologians, compromised,
175

on sin, 170
Theology, and ethical con-
cern, 184

language of, 143

misleading, 222, 232

pastoral, 74

perilous and arrogant, 175

primacy of, 220

and psychology, 176, 222

recovery of, 171

undisciplined, 171

vagaries of, 170, 173

vogues in, 170-171
Therapist, as father, 96
Therapists, secular, 224
Therapy, and action, 46

aim of, 30, 224

nature of, 35, 38

as personal growth, 34

to undo repression, 20

as transference, 25
Total depravity, 189
Transference, 113
Treatment, ambiguities of,
101

humane, 56

as instruction, 44

medical, 50

as redemption, 45

symptomatic, 153

and temptation, 120
Troubles, vs. issues, 135, 138

Subject

Typology, character, 2
Freudian, 236

Unconscious, benevole
conception of, 17 ff.
content of, 27
diabolical, 128
Freud's theory of, 1
and Holy Spirit, 12
neurological basis ol
re-examined, 28 ff., ;
and repression, 19 ffJ
vs. the unuttered, 1^
Uncovering, vs. coverii
Understanding, 41
Unreahty, sense of, 21

Values, contempt for,

moral, 143

nev^^ interest in, 52
Verification, of religioi

claims, 207
Virtue, and freedom.

Will power, source ol

228
Wisdom, secret, 113
Working through, in t

sion, 240
Wrath, of God, 154, 2

You, the real you, 178

Zen Buddhism, 181, 2"

4 22 16

^

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